Individual
JACK ANAVIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 DUDLEY ST, SUITE 200, PROVIDENCE, RI 02905-3236
(401) 444-3581
(401) 444-3609
Mailing address
2943 HIGHWAY 77, PANAMA CITY, FL 32405-4411
(850) 914-7060
(850) 914-7065
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
14549
RI
Other
Enumeration date
06/26/2009
Last updated
10/28/2021
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