Organization
HUGHSTON ORTHOPAEDIC SOUTHEAST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA GRACE FROMKIN (CREDENTIALING MANAGER)
(706) 494-3071
Entity
Organization
Contact information
Practice address
6699 GATE PKWY, JACKSONVILLE, FL 32256-8078
(904) 375-9753
Mailing address
6262 VETERANS PKWY, COLUMBUS, GA 31909-3540
(706) 494-3071
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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