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General NPI Number Information
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NPI Number | 1851797120
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Entity Type | Organization
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Legal Business Name | DOWN TIME HYPERBARICS AND EMERGENCY MEDICINE, PLLC
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Dates
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Enumeration Date | 11/13/2014
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Last Update Date | 11/13/2014
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Provider Practice Location Address
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Address Line | 6428 W HIGHWAY 98
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City | PORT ST JOE
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State | FL
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Zip | 32456-7401
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Country | US
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Telephone | 330-773-3544
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Fax | 330-773-3698
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Provider Business Mailing Address
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Address Line | 6428 W HIGHWAY 98
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City | PORT ST JOE
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State | FL
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Zip | 32456-7401
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Country | US
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Telephone | 330-773-3544
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Fax | 330-773-3698
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Authorized Official
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Title or Position | OWNER
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Name | JONATHAN EDWARD JONES
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Credential | MD
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Telephone | 330-773-3544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME108942
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License Number State | FL
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