Individual
DR. DAVID JEREMIAH MAGNESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
500 N WASHINGTON AVE, SUITE 105, TITUSVILLE, FL 32796-2759
(321) 268-0267
(321) 268-3357
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 952-9696
(321) 952-7937
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS11617
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005980800
—
FL
Enumeration date
04/15/2009
Last updated
11/19/2012
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