Individual
DR. WILLIAM JAMES MARVIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
841 PRUDENTIAL DR, UFJP PEDIATRIC CARDIOVASCULAR CENTER, JACKSONVILLE, FL 32207-8329
(904) 493-1610
(904) 493-2363
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME62973
FL
2080P0202X
Pediatric Cardiology Physician
Primary
ME62973
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000492863B
—
GA
05
—
0488640-00
—
FL
01
—
370001192
RAILROAD MEDICARE
FL
Enumeration date
03/18/2006
Last updated
03/30/2009
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