Healthcare Provider Details

I. General information

NPI: 1851391957
Provider Name (Legal Business Name): BETH ANN STARKEY DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1912 DEBARRY AVE
ORANGE PARK FL
32073-4626
US

IV. Provider business mailing address

2660 ORKNEY CT
ORANGE PARK FL
32065-6347
US

V. Phone/Fax

Practice location:
  • Phone: 904-708-7855
  • Fax: 904-278-5222
Mailing address:
  • Phone: 904-708-7855
  • Fax: 866-402-4005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH8645
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: