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General NPI Number Information
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NPI Number | 1780489617
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Entity Type | Organization
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Legal Business Name | PRECISION PHYSICIAN GROUP LLC
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 1540 BUSINESS CENTER DR STE A
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-4419
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Country | US
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Telephone | 904-481-5555
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Fax | 904-341-5760
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Provider Business Mailing Address
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Address Line | 4500 SALISBURY RD STE 200
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City | JACKSONVILLE
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State | FL
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Zip | 32216-0974
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Country | US
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Telephone | 904-481-5555
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Fax | 904-341-5760
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Authorized Official
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Title or Position | DIRECTOR
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Name | JOSHUA HAMMOND
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Credential |
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Telephone | 843-384-3512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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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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