Organization
PHYSICIAN GROUP HOLDINGS, LLC
Active
Other names
Ageless Vein Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEGAN ELIZABETH DEACON-CASEY MD (MEDICAL DIRECTOR)
(904) 990-8484
Entity
Organization
Contact information
Practice address
10210 SAN JOSE BLVD STE 4, JACKSONVILLE, FL 32257-6271
(904) 990-8484
(904) 990-8485
Mailing address
10210 SAN JOSE BLVD STE 4, JACKSONVILLE, FL 32257-6271
(904) 990-8484
(904) 990-8485
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
07/01/2019
Last updated
07/01/2019
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