| NPI | 1861661787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARNOLD DOUGLAS FONG Physician/President 904-280-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME65011) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2008-07-15 |