Mckennan J. Thurston
Family Doctor Family Doctor - Sports Medicine
4500 San Pablo Rd S
Jacksonville
, Florida 32224-1865
Mckennan J. Thurston
Family Doctor Family Doctor - Sports Medicine
4500 San Pablo Rd S
Jacksonville
, Florida 32224-1865
(801) 525-8151
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About
Features
Specialties
- Family Doctor
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Mckennan J. Thurston
- Po Box 337
- Layton, UT
- Zip : 84041-0337
- Fax : (801) 525-8151
- Phone : (801) 773-4840
Second Address
- Mckennan J. Thurston
- 4500 San Pablo Rd S
- Jacksonville, FL
- Zip : 32224-1865
- Phone : (904) 953-2000
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Is Mckennan J. Thurston a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Q00000X | Family Doctor | 56747 | MN |
| N | 207Q00000X | Family Doctor | ME123681 | FL |
| Y | 207QS0010X | Family Doctor - Sports Medicine | 9817986-1205 | UT |
National Provider Identifier
| NPI | 1194088856 |
|---|---|
| Provider Name | Mckennan J. Thurston |
| First Address | Layton, UT 84041-0337 |
| Second Address | Jacksonville, FL 32224-1865 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/06/2012 |
| Last Update Date | 14/06/2016 |
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.