Doctor Name: | WILLIAM J NAMEN |
NPI Number: | 1063500692 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | PO2208 |
Business Practice Address: | 1351 13th Avenue South Suite 110 Jacksonville Beach, FL - 32250 |
Business Phone Number: | 9046369197 |
Business Fax Number: | 9046369282 |
Mailing Address: | 9310 Old Kings Rd S, Suite 1201 JACKSONVILLE |
State: | FL |
Postal Code: | 322576152 |
Phone Number: | 9046369197 |
Fax Number: | 9046369282 |
NPI Enumeration Date: | 10/10/2006 |
NPI Last Update Date: | 11/30/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | PO2208 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |