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NPI Code Detail

MEDICARE: DR. RALPH M. BOONE D.O.

MEDICARE: DR. RALPH M. BOONE 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
1207QA0505XAdult Medicine PhysicianOS2986FL

General Provider Information

NPI Number : 1518929124
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RALPH M. BOONE D.O.
Provider Business Mailing Address
First Line : 1215 DUNN AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32218-6330
Country : US
Telephone Number : 904-757-1998
Fax Number : 904-696-7462
Provider Business Practice Location Address
First Line : 1215 DUNN AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32218-6330
Country : US
Telephone Number : 904-757-1998
Fax Number : 904-696-7462
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 05/07/2014

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