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Organization

JOHN W PUCKETT MD FACS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN WILLIS PUCKETT MD (VASCULAR SURGEON)
(949) 574-7176
Entity
Organization

Contact information

Practice address
520 SUPERIOR AVE., #370, NEWPORT BEACH, CA 92663-3623
(949) 574-7176
(979) 574-7180
Mailing address
520 SUPERIOR AVE, #370, NEWPORT BEACH, CA 92663-3637
(949) 574-7176
(979) 574-7180

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
G38172A
CA

Other

Enumeration date
04/24/2007
Last updated
02/03/2014
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