MEDICARE: DR. RONALD WARREN HOARD II M.D.

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	208600000X	Surgery Physician	91466	GA
2	390200000X	Student in an Organized Health Care Education/Training Program		MD
3	390200000X	Student in an Organized Health Care Education/Training Program		GA
4	2086S0102X	Surgical Critical Care Physician	ME163659	FL

General Provider Information

NPI Number	:	1932521036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD WARREN HOARD II M.D.

Provider Business Mailing Address
First Line	:	3627 UNIVERSITY BLVD S STE 305
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4294
Country	:	US
Telephone Number	:	904-593-0760
Fax Number	:	904-398-1729

Provider Business Practice Location Address
First Line	:	3627 UNIVERSITY BLVD S STE 305
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4294
Country	:	US
Telephone Number	:	904-593-0760
Fax Number	:	904-398-1729

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

Provider Enumeration Date	:	01/09/2014
Last Update Date	:	08/10/2023

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