MEDICARE: JOHN R PINKSTON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	24327	TN
2	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	24327	TN
3	207R00000X	Internal Medicine Physician	24327	TN
4	207R00000X	Internal Medicine Physician	ME163719	FL

General Provider Information

NPI Number	:	1194701391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN R PINKSTON MD

Provider Business Mailing Address
First Line	:	PO BOX 746638
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6638
Country	:	US
Telephone Number	:	904-202-1032
Fax Number	:	904-376-4107

Provider Business Practice Location Address
First Line	:	851042 US HIGHWAY 17
Second Line	:
City	:	YULEE
State	:	FL
Zip	:	32097-2845
Country	:	US
Telephone Number	:	904-225-3824
Fax Number	:	904-390-7440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	01/05/2024

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Directions to “ JOHN R PINKSTON MD” Practice Location

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