Individual
JOHN CHARLES AXLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5149 N 9TH AVE STE 120, PENSACOLA, FL 32504-8734
(850) 479-1805
Mailing address
1824 KING ST STE 200, JACKSONVILLE, FL 32204-4736
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
ME155618
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2016
Last updated
11/23/2022
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