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General NPI Number Information
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NPI Number | 1548244403
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Entity Type | Individual
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Provider Name | CHRIS B RATHBURN MD
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Gender | Male
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 12/06/2016
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Provider Practice Location Address
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Address Line | 7011 A C SKINNER PKWY SUITE 160
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6954
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Country | US
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Telephone | 904-622-9035
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Fax | 904-493-2222
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Provider Business Mailing Address
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Address Line | PO BOX 551308
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City | JACKSONVILLE
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State | FL
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Zip | 32255-1308
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Country | US
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Telephone | 904-493-3333
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Fax | 904-493-2222
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME43492
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License Number State | FL
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