Organization
ANESTHESIA ASSOCIATES OF CLAY COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY PAYNE (CREDENTIALING)
(904) 421-2119
Entity
Organization
Contact information
Practice address
1665 KINGSLEY AVE, SUITE 105, ORANGE PARK, FL 32073-4490
(904) 215-7015
Mailing address
PO BOX 850001, DEPT 121, ORLANDO, FL 32885-0001
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060925100
—
FL
Enumeration date
08/12/2005
Last updated
01/21/2016
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