Individual
ELLEN C. SACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6142 COLLINS RD, CREDENTIALING DEPARTMENT, JACKSONVILLE, FL 32244-5806
(904) 778-3200
(904) 778-9835
Mailing address
PO BOX 40767, CREDENTIALING DEPARTMENT, JACKSONVILLE, FL 32203-0767
(904) 376-3707
(904) 391-5807
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME54002
FL
Other
Enumeration date
03/11/2006
Last updated
02/02/2015
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