Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 9110692 | FL |
NPI | 1013436252 |
---|---|
Provider Name | Ryan N Pafford |
First Address | Jacksonville, FL 32209-6533 |
Second Address | Jacksonville, FL 32209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2017 |
Last Update Date | 02/10/2017 |