Individual
JEFFREY HOWARD WACHHOLZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2700 RIVERSIDE AVE, SUITE 7, JACKSONVILLE, FL 32205-8275
(904) 389-3223
(904) 388-5902
Mailing address
2700 RIVERSIDE AVE, SUITE 7, JACKSONVILLE, FL 32205-8275
(904) 389-3223
(904) 388-5902
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
ME76268
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
288187
AVMED
—
01
—
46857
BLUE CROSS BLUE SHIELD
FL
01
—
7137740
AETNA
FL
Enumeration date
03/20/2007
Last updated
07/08/2007
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