Organization
BRUCE S. WEST
Active
Other names
Bruce S. West, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE S WEST M.D. (OWNER)
(904) 261-7707
Entity
Organization
Contact information
Practice address
1340 S 18TH ST, STE. 203, FERNANDINA BEACH, FL 32034-4799
(904) 261-7707
(904) 261-8616
Mailing address
1340 S 18TH ST, STE. 203, FERNANDINA BEACH, FL 32034-4799
(904) 261-7707
(904) 261-8616
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
0101042844
VA
261QP2300X
Primary Care Clinic/Center
Primary
ME99878
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006734952
—
VA
05
—
113328677A
—
GA
05
—
280146900
—
FL
Enumeration date
05/20/2007
Last updated
08/17/2015
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