Organization
SOUTHEASTERN HAND CENTER, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK LEELAND GREIDER JR. MD (PRESIDENT)
(904) 733-5550
Entity
Organization
Contact information
Practice address
6100 KENNERLY RD, SUITE 202, JACKSONVILLE, FL 32216-4368
(904) 733-5550
(904) 733-5515
Mailing address
6100 KENNERLY RD, SUITE 202, JACKSONVILLE, FL 32216-4368
(904) 733-5550
(904) 733-5515
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
ME27693
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37943300
—
FL
Enumeration date
09/29/2006
Last updated
10/26/2011
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