Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | ME47879 | FL |
NPI | 1043298904 |
---|---|
Provider Name | George K Adcock |
First Address | Maitland, FL 32751-5619 |
Second Address | Maitland, FL 32751-5619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2006 |
Last Update Date | 10/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D85829 | (02) | FL |