Individual
MITCHELL D TERK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 LOMAX ST, SUITE 1, JACKSONVILLE, FL 32204-4004
(904) 483-2310
(904) 483-2313
Mailing address
7017 A C SKINNER PKWY, JACKSONVILLE, FL 32256-6932
(904) 520-6800
(904) 520-6801
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME73925
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
226458
AVMED
FL
05
—
255850500
—
FL
01
—
42370
BCBS
FL
01
—
P00191302
RAILROAD MEDICARE
FL
Enumeration date
04/27/2006
Last updated
04/11/2018
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