Individual
DR. BEDFORD HUDSON BERREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 PALM AVE, JACKSONVILLE, FL 32207-8432
(904) 202-7300
(904) 202-7433
Mailing address
PO BOX 45278, JACKSONVILLE, FL 32232-5278
(904) 202-2092
(904) 393-7603
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
ME74636
FL
2086X0206X
Surgical Oncology Physician
Primary
ME74636
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000809718B
—
GA
01
—
200044245
RR CARE
—
05
—
2505126-00
—
FL
Enumeration date
03/28/2006
Last updated
12/11/2019
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