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Individual

MATTHEW HALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
655 W 8TH ST, UFJP EMERGENCY MEDICINE, JACKSONVILLE, FL 32209-6511
(904) 244-4984
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME103060
FL
207P00000X
Emergency Medicine Physician
TRN10165
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0012042-00
FL
01
145NM
BCBS - FL
FL
05
666994843B
GA
Enumeration date
01/12/2007
Last updated
04/19/2010
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