| NPI | 1881644912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE ETZKORN Executive VP Of Operations 904-398-7205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 208C00000X Colon & Rectal Surgery | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2015-06-24 |