Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 2019-01080 | NC |
NPI | 1053734517 |
---|---|
Provider Name | Justin Fincher |
First Address | Pensacola, FL 32512-0001 |
Second Address | Pensacola, FL 32512-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2014 |
Last Update Date | 06/10/2021 |