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Individual

JEFFREY LEE LORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4012 N 9TH AVE, PENSACOLA, FL 32503-2824
(850) 444-4777
(850) 434-3387
Mailing address
11945 SAN JOSE BLVD, STE 300, JACKSONVILLE, FL 32223-1613
(904) 396-1725
(904) 399-1717

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101049921
VA
208600000X
Surgery Physician
Primary
1016949
MA
208600000X
Surgery Physician
ME92672
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
23796300
FL
Enumeration date
01/31/2006
Last updated
12/04/2024
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