Individual
ERIC W SHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1205 BEACH BLVD, JACKSONVILLE BEACH, FL 32250-3405
(904) 389-0346
(904) 246-5449
Mailing address
2236 PARK ST, JACKSONVILLE, FL 32204-4316
(904) 389-0346
(904) 389-1142
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO1898
FL
213EP0504X
Public Medicine Podiatrist
PO1898
FL
213EP1101X
Primary Podiatric Medicine Podiatrist
PO1898
FL
213ER0200X
Radiology Podiatrist
PO1898
FL
213ES0000X
Sports Medicine 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
01/11/2008
Last updated
04/03/2017
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