Clark & Daughtrey Medical Group Pa

NPI 1063543775 - Internal Medicine - 207RC0000X

NPI Details
NPI 1063543775
Enumeration Date 03/07/2007
Last Updated 06/30/2015
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name EVAN C. EVAN
Position VICE PRESIDENT, CHIEF FINANCIAL OFF
Phone (863) 284-5941
Fax
Practice Location
130 PABLO ST
LAKELAND FL, 33803-3818, US
Phone (863) 284-5941
Fax
Business Location
PO BOX 917394
ORLANDO FL, 32891-7394, US
Phone (863) 284-5941
Fax
Toxanomy
Taxonomy Code 207RC0000X
License State
License Number
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According to our database, Clark & Daughtrey Medical Group Pa NPI is 1063543775, taxonomy code is 207RC0000X Clark & Daughtrey Medical Group Pa physically located at 130 Pablo St, Lakeland FL, 33803-3818. NPI Number 1033115704 has the healthcare provider type.

1063543775 NPI number is provided on an as is basis without warranty of any kind. 1063543775 is maintained by the National Plan & Provider Enumeration System. The contents of Clark & Daughtrey Medical Group Pa are for informational purposes only.