Individual
ROGER GIFFORD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 BARRS ST, JACKSONVILLE, FL 32204-4704
(904) 388-1562
(904) 399-1841
Mailing address
1800 BARRS ST, JACKSONVILLE, FL 32204-4704
(904) 388-1562
(904) 399-1841
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME0015916
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35942400
—
FL
Enumeration date
05/05/2006
Last updated
07/08/2007
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