MEDICARE: DR. JUSTIN FRANCIS DEVITO DO

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	2080P0206X	Pediatric Gastroenterology Physician	02002842A	IN

General Provider Information

NPI Number	:	1952398794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN FRANCIS DEVITO DO

Provider Business Mailing Address
First Line	:	BROOKE ARMY MEDICAL CENTER
Second Line	:	3551 ROGER BROOKE DRIVE
City	:	SAN ANTONIO
State	:	TX
Zip	:	78234
Country	:	US
Telephone Number	:	803-312-1745
Fax Number	:

Provider Business Practice Location Address
First Line	:	BROOKE ARMY MEDICAL CENTER
Second Line	:	3551 ROGER BROOKE DRIVE
City	:	SAN ANTONIO
State	:	TX
Zip	:	78234
Country	:	US
Telephone Number	:	803-312-1745
Fax Number	:

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

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	08/25/2023

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