Organization
DARREL W WYATT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARREL W WYATT MD (PRESIDENT)
(386) 325-1629
Entity
Organization
Contact information
Practice address
700 ZEAGLER DR, SUITE 9, PALATKA, FL 32177-6806
(386) 325-1629
(386) 325-8611
Mailing address
700 ZEAGLER DR, SUITE 9, PALATKA, FL 32177-6806
(386) 325-1629
(386) 325-8611
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038781900
—
FL
Enumeration date
12/02/2014
Last updated
12/02/2014
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