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Organization
T R SUGGS MD MEDICAL CLINIC PA
Active
Organization
T R SUGGS MD MEDICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THELBERT R SUGGS MD (OWNER)
(386) 698-1221
Entity
Organization
Contact information
Practice address
300 S MAIN ST, CRESCENT CITY, FL 32112-2729
(386) 698-1221
(386) 698-1514
Mailing address
PO BOX 98, CRESCENT CITY, FL 32112-0098
(386) 698-1221
(386) 698-1514
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012686688
RAILROAD MEDICARE
FL
05
—
045328500
—
FL
Enumeration date
02/09/2010
Last updated
08/12/2010
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