Healthcare Provider Details

I. General information

NPI: 1366470023
Provider Name (Legal Business Name): PHILIP JOSEPH HESS JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 100129
GAINESVILLE FL
32610-0129
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-5470
  • Fax: 352-627-4173
Mailing address:
  • Phone: 352-265-5470
  • Fax: 352-627-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number01075386A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberME70541
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: