Individual
DR. GREGORY CARL WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, UFJP RADIOLOGY DEPARTMENT, JACKSONVILLE, FL 32209-6511
(904) 244-4782
(904) 244-3382
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME54066
FL
Other
Enumeration date
02/15/2006
Last updated
03/04/2008
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