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General NPI Number Information
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NPI Number | 1952678310
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Entity Type | Organization
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Legal Business Name | WENDELL J. COURTNEY, M.D.,P.A.
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Dates
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Enumeration Date | 11/29/2011
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | 601 E DIXIE AVE STE 301
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City | LEESBURG
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State | FL
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Zip | 34748-7302
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Country | US
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Telephone | 352-787-1001
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Fax |
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Provider Business Mailing Address
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Address Line | 601 E DIXIE AVE STE 301
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City | LEESBURG
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State | FL
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Zip | 34748-7302
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Country | US
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Telephone | 352-787-1001
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WENDELL JOHN COURTNEY
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Credential | M.D.
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Telephone | 352-787-1001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME50296
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License Number State | FL
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