Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | ME102983 | FL |
Y | 208D00000X | General Practice Physician | 29800 | GA |
NPI | 1043248537 |
---|---|
Provider Name | Dr. John Robert Stripling III |
First Address | West Palm Beach, FL 33406-7832 |
Second Address | West Palm Beach, FL 33406-7832 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 02/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00398428A | (05) | GA |
1043248537 | (02) | GA |
B30820 | (02) | GA |