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General NPI Number Information
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NPI Number | 1518119361
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Entity Type | Individual
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Provider Name | MICHAEL DREW KIGHT P,A.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2008
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Last Update Date | 12/03/2012
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Provider Practice Location Address
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Address Line | 1201 MONUMENT RD SUITE 201B
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City | JACKSONVILLE
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State | FL
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Zip | 32225-7411
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Country | US
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Telephone | 904-727-5151
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Fax | 904-727-3887
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Provider Business Mailing Address
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Address Line | PO BOX 61148
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City | JACKSONVILLE
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State | FL
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Zip | 32236-1148
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Country | US
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Telephone | 904-400-6100
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Fax | 904-400-6102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0003849
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License Number State | MD
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