MEDICARE: DR. RICHARD DOUGLAS QUATTRONE D.O.

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	207Q00000X	Family Medicine Physician	20A6508	CA

General Provider Information

NPI Number	:	1457331712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD DOUGLAS QUATTRONE D.O.

Provider Business Mailing Address
First Line	:	175 DOCKSIDE DR
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-9769
Country	:	US
Telephone Number	:	910-382-8393
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 BREWSTER BLVD
Second Line	:	DEPT OF FAMILY MEDICINE
City	:	CAMP LEJEUNE
State	:	NC
Zip	:	28547-2538
Country	:	US
Telephone Number	:	910-450-4580
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	07/08/2007

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