Organization Name: | JOHN E KERN DO PA |
NPI Number: | 1003116625 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN ERIC KERN (PRESIDENT) |
Mailing Address: | 5838 9th Ave N St Petersburg |
State: | FL US |
Postal Code: | 337106319 |
Phone Number: | 7273478132 |
Fax Number: | 7273473560 |
NPI Enumeration Date: | 10/29/2010 |
NPI Last Update Date: | 10/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | OS0005648 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |