Healthcare Provider Details

I. General information

NPI: 1508956517
Provider Name (Legal Business Name): JAMES MARK ESSER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 MANGRUM DR
DUNEDIN FL
34698-2228
US

IV. Provider business mailing address

4500S GARNETT RD 919
TULSA OK
74146-5214
US

V. Phone/Fax

Practice location:
  • Phone: 727-738-0190
  • Fax:
Mailing address:
  • Phone: 918-392-2944
  • Fax: 844-876-0881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME 57602
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberK8744
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: