Individual
DR. GEORGE LEONARD ETTEL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7050 AIR DEPOT BLVD BLDG 1094, TINKER AFB, OK 73145-8716
(727) 667-0390
(405) 736-3619
Mailing address
502 W HIGHLAND BLVD, INVERNESS, FL 34452-4720
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2020
Last updated
03/07/2022
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