Healthcare Provider Details

I. General information

NPI: 1013349802
Provider Name (Legal Business Name): PUTNAM PHYSICIANS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2013
Last Update Date: 03/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ZEAGLER DR SUITE 430
PALATKA FL
32177-3883
US

IV. Provider business mailing address

3426 NW 43RD ST SUITE B
GAINESVILLE FL
32606-8156
US

V. Phone/Fax

Practice location:
  • Phone: 386-238-2990
  • Fax: 386-530-2067
Mailing address:
  • Phone: 352-338-2089
  • Fax: 386-530-2067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. PERINCHERY NARAYAN
Title or Position: PRESIDENT
Credential: MD
Phone: 352-338-2089