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General NPI Number Information
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NPI Number | 1780473298
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Entity Type | Organization
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Legal Business Name | DUVAL MEDICAL, P.A.
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 2064 PARK ST
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City | JACKSONVILLE
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State | FL
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Zip | 32204-3810
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Country | US
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Telephone | 859-550-6526
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Fax |
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Provider Business Mailing Address
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Address Line | 2064 PARK ST
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City | JACKSONVILLE
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State | FL
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Zip | 32204-3810
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Country | US
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Telephone | 859-550-6526
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | JOSHUA E FAUCETT
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Credential | DNP
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Telephone | 859-550-6526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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