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Individual

DR. TIMOTHY P. BESSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 202-8275
(904) 396-1630
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(904) 288-5890

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME46665
FL
207LP3000X
Pediatric Anesthesiology Physician
Primary
ME46665
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
042416100
FL
05
824535897A
GA
Enumeration date
08/20/2006
Last updated
09/03/2011
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