Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN15173 | FL |
Y | 213EG0000X | General Practice | DN15173 | FL |
NPI | 1003941568 |
---|---|
Provider Name | Dr. Cynthia Dickson Haug- Brush |
First Address | Jonesville, FL 32669 |
Second Address | Jonesville, FL 32669 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 19/08/2010 |