Organization
PUTNAM PHYSICIAN PRACTICES LLC
Active
Other names
Putnam Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
JESS JUDY (PRESIDENT)
(615) 372-8500
Entity
Organization
Contact information
Practice address
414 ZEAGLER DR, PALATKA, FL 32177-3815
(386) 328-4123
(386) 328-4125
Mailing address
414 ZEAGLER DR, PALATKA, FL 32177-3815
(386) 328-4123
(386) 328-4125
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BL990A
MEDICARE PTAN
FL
Enumeration date
07/31/2008
Last updated
06/14/2010
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