Healthcare Provider Details

I. General information

NPI: 1033227707
Provider Name (Legal Business Name): WILLIAM E. PALIN JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 12/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 3RD ST SUITE 303
NEPTUNE BEACH FL
32266-5072
US

IV. Provider business mailing address

700 3RST STREET SUITE 303
NEPTUNE BEACH FL
32266
US

V. Phone/Fax

Practice location:
  • Phone: 904-247-0148
  • Fax: 904-247-0574
Mailing address:
  • Phone: 904-247-0148
  • Fax: 904-247-0574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME101653
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: