Organization
ATLANTIC UROLOGICAL ASSOCIATES P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRI CREGGAR (CHIEF OPERATING OFFICER)
(386) 239-8500
Entity
Organization
Contact information
Practice address
2460 OLD MOULTRIE RD, SUITE 5, ST AUGUSTINE, FL 32086-4197
(904) 794-7870
Mailing address
545 HEALTH BLVD, DAYTONA BEACH, FL 32114-1493
(386) 239-8500
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
05/01/2007
Last updated
02/14/2008
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