Organization
JASON B WIDRICH MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON B WIDRICH MD (OWNER)
(904) 608-4558
Entity
Organization
Contact information
Practice address
3625 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4207
(904) 387-0006
Mailing address
852 CHANTERELLE WAY, SAINT JOHNS, FL 32259-8000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
04/17/2007
Last updated
08/27/2014
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