MEDICARE: WILLIAM V CHOISSER MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	ME0053605	FL
2	208D00000X	General Practice Physician	ME0039226	FL
3	207Q00000X	Family Medicine Physician	ME0032641	FL

General Provider Information

NPI Number	:	1215909122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM V CHOISSER MD PA

Provider Business Mailing Address
First Line	:	1677 WELLS RD STE A
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-2383
Country	:	US
Telephone Number	:	904-264-2297
Fax Number	:	904-264-6266

Provider Business Practice Location Address
First Line	:	1677 WELLS RD STE A
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-2383
Country	:	US
Telephone Number	:	904-264-2297
Fax Number	:	904-264-6266

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. JENNIFER GREENE
Credential	:
Telephone Number	:	904-264-2297

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	03/21/2024

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