Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 31786 | MI |
N | 111NI0900X | Internist | 31786 | MI |
N | 207RA0401X | Internist - Addiction Medicine | 31786 | MI |
N | 207RC0000X | Internist - Cardiovascular Disease | 31786 | MI |
N | 207RG0100X | Gastroenterologist | 31786 | MI |
N | 207RG0300X | Geriatric Medicine | 31786 | MI |
Y | 207RG0300X | Geriatric Medicine | ME99452 | FL |
NPI | 1598868069 |
---|---|
Provider Name | Asok Kumar Roy |
First Address | Jacksonville, FL 32245-7577 |
Second Address | Jacksonville, FL 32207-3814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 24/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002831500 | (05) | FL |
B46658 | (02) |