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Individual

MAX T BILLINGSLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 SHIRCLIFF WAY, EMERGENCY DEPARTMENT, JACKSONVILLE, FL 32204-4748
(904) 346-5426
(904) 346-0113
Mailing address
PO BOX 863026, ORLANDO, FL 32886-3026
(904) 346-5426
(904) 346-0113

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
ME0045015
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
044556800
FL
01
14148
BCBS
FL
01
930000750
RRMCR
FL
Enumeration date
05/03/2006
Last updated
12/01/2008
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