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General NPI Number Information
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NPI Number | 1306960976
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Entity Type | Organization
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Legal Business Name | PATRICIA M FEARING
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/29/2007
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Provider Practice Location Address
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Address Line | 6440 W NEWBERRY RD STE 202
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City | GAINESVILLE
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State | FL
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Zip | 32605-4369
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Country | US
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Telephone | 352-331-3736
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Fax | 352-333-7834
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Provider Business Mailing Address
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Address Line | 6440 W NEWBERRY RD STE 202
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City | GAINESVILLE
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State | FL
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Zip | 32605-4369
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Country | US
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Telephone | 352-331-3736
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Fax | 352-333-7834
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Authorized Official
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Title or Position | OWNER
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Name | PATRICIA MORRIS FEARING
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Credential | MD
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Telephone | 352-331-3736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | ME49830
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License Number State | FL
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