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General NPI Number Information
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NPI Number | 1124460530
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Entity Type | Organization
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Legal Business Name | JDG CIRCLE INPATIENT SERVICES LLC
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Dates
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Enumeration Date | 07/26/2013
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Last Update Date | 08/29/2019
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Provider Practice Location Address
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Address Line | 18167 US HIGHWAY 19 N SUITE #650
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City | CLEARWATER
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State | FL
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Zip | 33764-3528
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Country | US
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Telephone | 727-437-0818
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Fax |
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Provider Business Mailing Address
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Address Line | 3651 WHEELER RD
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City | AUGUSTA
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State | GA
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Zip | 30909-6521
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/MD
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Name | GREGORY J. BYRNE
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Credential |
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Telephone | 954-838-2371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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