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Individual

DR. BRIAN JOHN DEEGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2370 MARKET DR, FLEMING ISLAND, FL 32003
(904) 264-6201
(904) 264-6858
Mailing address
7015 A C SKINNER PKWY STE 1, JACKSONVILLE, FL 32256-6932
(904) 363-2113
(904) 363-2606

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME135085
FL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
024277400
FL
01
H6U17
FL BLUE
FL
01
JK033Z
MEDICARE
FL
01
P02093071
RR MEDICARE
FL
Enumeration date
04/19/2013
Last updated
10/29/2018
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