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Individual

JAMES W. WYNNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-8740
(352) 392-0821
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 273-8740
(352) 392-0821

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
ME0017582
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME17582
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
052750500
FL
Enumeration date
02/15/2006
Last updated
10/01/2009
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