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Individual

JOHN AXLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4400 BAYOU BLVD STE 43, PENSACOLA, FL 32503-1910
(850) 477-3015
(850) 477-3026
Mailing address
4400 BAYOU BLVD STE 43, PENSACOLA, FL 32503-1910
(850) 477-3015
(850) 477-3026

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
00007052
AL
2084N0400X
Neurology Physician
Primary
ME20237
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009945805
AL
05
052598700
FL
01
406132045
RRB PTAN
Enumeration date
11/16/2006
Last updated
10/30/2007
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