Individual
DR. JOHN WILLIS PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 SUPERIOR AVE, #370, NEWPORT BEACH, CA 92663-3637
(949) 574-7176
(949) 574-7180
Mailing address
520 SUPERIOR AVE, #370, NEWPORT BEACH, CA 92663-3637
(949) 574-7176
(949) 574-7180
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
G38172A
CA
Other
Enumeration date
09/29/2006
Last updated
01/27/2014
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