Individual
DR. GEORGE DOUGLAS LETSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12902 MAGNOLIA DR, SUITE 5036, TAMPA, FL 33612-9416
(813) 745-3976
(813) 745-8337
Mailing address
2503 N DUNDEE ST, TAMPA, FL 33629-6406
(813) 745-3976
(813) 745-8337
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0064409
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12167
BLUE CROSS BLUE SHIELD
FL
05
—
373191000
—
FL
Enumeration date
01/23/2006
Last updated
07/08/2007
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