Russell Raymond Jaicks M.D.

NPI 1184727414 - Surgery - 208600000X

NPI Details
NPI 1184727414
Gender Male
Enumeration Date 09/05/2006
Last Updated 04/18/2013
Entity Type Individual
Active Over 10 years ago
Practice Location
720 W OAK ST
SUITE 101
KISSIMMEE FL, 34741-4989, US
Phone (407) 846-3166
Fax
Business Location
720 W OAK ST
STE 101
KISSIMMEE FL, 34741-4989, US
Phone (407) 846-3166
Fax
Toxanomy
Taxonomy Code 208600000X
License State Florida
License Number ME113621
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According to our database, Russell Raymond Jaicks M.D. NPI is 1184727414, taxonomy code is 208600000X and license number is ME113621, license state is located at Florida. Russell Raymond Jaicks M.D. physically located at 720 W Oak St, Kissimmee FL, 34741-4989. NPI Number Russell Raymond Jaicks M.D. has the Individual type.

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1184727414 NPI number is provided on an as is basis without warranty of any kind. 1184727414 is maintained by the National Plan & Provider Enumeration System. The contents of Russell Raymond Jaicks M.D. are for informational purposes only.