Healthcare Provider Details

I. General information

NPI: 1215909122
Provider Name (Legal Business Name): WILLIAM V CHOISSER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1677 WELLS RD STE A
ORANGE PARK FL
32073-2383
US

IV. Provider business mailing address

1677 WELLS RD STE A
ORANGE PARK FL
32073-2383
US

V. Phone/Fax

Practice location:
  • Phone: 904-264-2297
  • Fax: 904-264-6266
Mailing address:
  • Phone: 904-264-2297
  • Fax: 904-264-6266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME0032641
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME0053605
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME0039226
License Number StateFL

VIII. Authorized Official

Name: MRS. CORA THOMPSON
Title or Position: OFFICE MANAGER
Credential: ADMINISTRATIVE
Phone: 904-264-2297