Individual
JONATHAN LORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
135 LONG POINT DR, FERNANDINA BEACH, FL 32034-6410
(904) 310-9511
Mailing address
135 LONG POINT DR, FERNANDINA BEACH, FL 32034-6410
(904) 310-9511
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
36359
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
106931
FL
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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