Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 2901012058 | MI |
N | 1223G0001X | General Practice | 2901012058 | MI |
N | 213EG0000X | General Practice | 2901012058 | MI |
NPI | 1003886300 |
---|---|
Provider Name | Dr. Ronald Appleby |
First Address | Jacksonville, FL 32224-7696 |
Second Address | Jacksonville, FL 32214-5005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 08/07/2007 |