Individual
DR. WILLIE JAMES HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
BREVARD COUNTY HEALTH DEPARTMENT, 2575 N COURTNEY PKWY, MERRITT ISLAND, FL 32953
(321) 454-7148
(321) 449-5015
Mailing address
BREVARD COUNTY HEALTH DEPARTMENT, 2575 N COURTNEY PKWY, MERRITT ISLAND, FL 32953
(321) 454-7148
(321) 449-5015
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DN0009634
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
077730700
—
FL
Enumeration date
12/15/2006
Last updated
12/12/2012
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