Lyle E Wadsworth Md Pa

NPI 1205018207 - Internal Medicine - 207RG0300X

NPI Details
NPI 1205018207
Enumeration Date 11/30/2007
Last Updated 03/06/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name LYLE E. LYLE
Position PRESIDENT
Phone (386) 740-0224
Fax
Practice Location
890 N BOUNDARY AVE STE 102
DELAND FL, 32720-3173, US
Phone (386) 740-0224
Fax
Business Location
890 N BOUNDARY AVE STE 102
DELAND FL, 32720-3173, US
Phone (386) 740-0224
Fax
Toxanomy
Taxonomy Code 207RG0300X
License State Florida
License Number ME30902
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According to our database, Lyle E Wadsworth Md Pa NPI is 1205018207, taxonomy code is 207RG0300X and license number is ME30902, license state is located at Florida. Lyle E Wadsworth Md Pa physically located at 890 N Boundary Ave Ste 102, Deland FL, 32720-3173. NPI Number 1033115704 has the healthcare provider type.

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1205018207 NPI number is provided on an as is basis without warranty of any kind. 1205018207 is maintained by the National Plan & Provider Enumeration System. The contents of Lyle E Wadsworth Md Pa are for informational purposes only.