Individual
KENNETH ALBERT TERHAAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3599 UNIVERSITY BLVD S, BLDG 300, JACKSONVILLE, FL 32216
(904) 399-5550
(904) 346-4334
Mailing address
2080 CHILD ST, JACKSONVILLE, FL 32214
(904) 542-7363
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101233211
VA
Other
Enumeration date
09/15/2005
Last updated
02/27/2019
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