Organization
NAVAL HOSPITAL JACKSONVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELAINE WAGNER DENTIST (EXECUTIVE OFFICER)
(904) 542-7312
Entity
Organization
Contact information
Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-7787
(904) 542-7651
Mailing address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-7787
(904) 542-7651
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J0352
TX
Other
Enumeration date
01/17/2006
Last updated
06/18/2008
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