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Individual

DR. GEORGE OTTO MABRY JR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
PO2788
FL
213ER0200X
Radiology Podiatrist
JR3863700
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0380220001
CIGNA ID #
FL
01
2900719
AETNA HMO/QPOS ID #
FL
05
340672500
FL
01
65612
BCBS ID
FL
01
7781081
AETNA PPO/POS ID #
FL
Enumeration date
03/31/2006
Last updated
12/27/2016
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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