Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME66544 | FL |
Y | 208600000X | Surgeon | ME66544 | FL |
NPI | 1003898982 |
---|---|
Provider Name | John D Brinkman |
First Address | Jacksonville, FL 32223-1627 |
Second Address | Orange Park, FL 32073-9207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 04/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020029570 | RAILROAD MEDICARE (01) | FL |
239210 | AVMED (01) | FL |
25509 | BCBS FL (01) | FL |
275828800 | (05) | FL |
4506932 | AETNA (01) | FL |
47072366813 | (05) | NE |
9912625 | CIGNA (01) | FL |
F79436 | (02) | NE |