Organization
QUICMED WALK IN CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN T CHACKO MD (MANAGING DIRECTOR)
(352) 522-1101
Entity
Organization
Contact information
Practice address
11223 N WILLIAMS ST, DUNNELLON, FL 34432-8350
(352) 522-1101
Mailing address
11223 N WILLIAMS ST, DUNNELLON, FL 34432-8350
(352) 522-1101
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME74735
FL
207R00000X
Internal Medicine Physician
ME74735
FL
208D00000X
General Practice Physician
Primary
ME74735
FL
Other
Enumeration date
09/10/2007
Last updated
12/20/2008
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