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Individual

DR. JEFFREY WAYNE BALTZER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
732 N 3RD ST, LEESBURG, FL 34748-4442
(352) 365-4575
(352) 273-8172
Mailing address
PO BOX 100275, GAINESVILLE, FL 32610-0275
(352) 273-7839
(352) 273-8172

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
188249-1
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD028023E
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME124617
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0017380000001
PA
05
015363200
FL
05
01927128
NY
01
220029208
RR MEDICARE PIN
PA
01
CC9269
RR MEDICARE GROUP
PA
01
GU039827
MEDICARE GROUP
PA
Enumeration date
02/07/2006
Last updated
02/23/2022
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