Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1618 | FL |
Y | 222Z00000X | Podiatrist | 1618 | FL |
NPI | 1053328518 |
---|---|
Provider Name | Dr. John Alan Prior |
First Address | Gainesville, FL 32653-3201 |
Second Address | Gainesville, FL 32608-1197 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
41147706 | (05) | FL |
T55579 | (02) |