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Organization
HARRIS WILCOX AND DONOVAN PA
Active
Organization
HARRIS WILCOX AND DONOVAN PA
Active
Other names
Clay Eye Physicians and Surgeons, PA- Mandarin
Organization subpart
No
Provider details
NPI number
Authorized official
MISS BOBBIE WILLIAMS (BILLING MANAGER)
(904) 272-2020
Entity
Organization
Contact information
Practice address
11790 SAN JOSE BL, JACKSONVILLE, FL 32223
(904) 272-2020
(904) 272-5762
Mailing address
11790 SAN JOSE BLVD, JACKSONVILLE, FL 32223-1836
(904) 765-2020
(904) 272-5762
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
FL
156FC0800X
Contact Lens Technician/Technologist
—
FL
174400000X
Specialist
—
FL
207W00000X
Ophthalmology Physician
Primary
—
FL
332H00000X
Eyewear Supplier
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
98904
MEDICARE GROUP # CLINICAL
FL
01
—
CB1273
MCR RAILROAD
FL
Enumeration date
04/05/2011
Last updated
06/27/2024
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