Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | ME0078606 | FL |
NPI | 1023028461 |
---|---|
Provider Name | Dr. Oscar Hunt Jerkins |
First Address | Rockledge, FL 32955 |
Second Address | Rockledge, FL 32955-2945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
080193261 | RR MEDICARE (01) | FL |
1902878 | UNITED HEALTHCARE (01) | FL |
256742300 | (05) | FL |
46976 | BLUE CROSS BLUE SHIELD (01) | FL |
6237509 | CIGNA (01) | FL |
7497042 | AETNA (01) | FL |
GOO540 | (02) | FL |
P00950572 | RAILROAD MEDICARE (01) | FL |