Jeffrey Howard Wachholz
Facial Plastic Surgeon
2700 Riverside Ave Suite 7
Jacksonville
, Florida 32205-8275
Jeffrey Howard Wachholz
Facial Plastic Surgeon
2700 Riverside Ave Suite 7
Jacksonville
, Florida 32205-8275
(904) 388-5902
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About
Features
Specialties
- Facial Plastic Surgeon
Languages spoken
- English
Location
First Address
- Jeffrey Howard Wachholz
- 2700 Riverside Ave Suite 7
- Jacksonville, FL
- Zip : 32205-8275
- Fax : (904) 388-5902
- Phone : (904) 389-3223
Second Address
- Jeffrey Howard Wachholz
- 2700 Riverside Ave Suite 7
- Jacksonville, FL
- Zip : 32205-8275
- Fax : (904) 388-5902
- Phone : (904) 389-3223
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YS0123X | Facial Plastic Surgeon | ME76268 | FL |
National Provider Identifier
| NPI | 1508981689 |
|---|---|
| Provider Name | Jeffrey Howard Wachholz |
| First Address | Jacksonville, FL 32205-8275 |
| Second Address | Jacksonville, FL 32205-8275 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/03/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 288187 | AVMED (01) | |
| 46857 | BLUE CROSS BLUE SHIELD (01) | FL |
| 7137740 | AETNA (01) | FL |
| H02209 | (02) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.