# ORIGINS FAMILY MEDICAL & WEIGHT LOSS CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962835306
- **Authorized official:** MR. DUANE E. THOMAS ESQ. (PRESIDENT/DIRECTOR)
- **Authorized official phone:** (386) 755-5014

## Contact information

- **Practice address:** 206 S MARION AVE, LAKE CITY, FL 32025-7058
- **Practice address phone:** (386) 755-5014
- **Practice address fax:** (386) 755-3093
- **Mailing address:** 194 SW WALL TER, LAKE CITY, FL 32025-5086
- **Mailing address phone:** (386) 719-9227
- **Mailing address fax:** (386) 719-9488

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/20/2013
- **Last updated:** 09/12/2013