Organization
ERIC W SHULTZ DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLEY M LUNDEEN DPM (OFFICE MANAGER)
(904) 551-1765
Entity
Organization
Contact information
Practice address
10250 NORMANDY BLVD, SUITE 205, JACKSONVILLE, FL 32221-0000
(904) 551-1765
(904) 388-8263
Mailing address
10250 NORMANDY BLVD, SUITE 205, JACKSONVILLE, FL 32221-0000
(904) 551-1765
(904) 527-3857
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO1898
FL
213EP0504X
Public Medicine Podiatrist
PO1898
FL
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
PO1898
FL
213ER0200X
Radiology Podiatrist
PO1898
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO1898
FL
213ES0131X
Foot Surgery Podiatrist
PO1898
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390193900
—
FL
01
—
480020923
MEDICARE RAILROAD
FL
01
—
65159
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/04/2007
Last updated
07/08/2011
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