Individual
JEFFERY S MAGNUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
410 CELEBRATION PL, SUITE 305, CELEBRATION, FL 34747-5433
(407) 303-4120
(407) 303-4124
Mailing address
410 CELEBRATION PL, SUITE 305, CELEBRATION, FL 34747-5433
(407) 303-4120
(407) 303-4124
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
19372
AL
207Y00000X
Otolaryngology Physician
ME113411
FL
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
ME113411
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000020880
BLUE CROSS
AL
05
—
000020880
—
AL
05
—
009965835
—
AL
01
—
051517997
BLUE CROSS
AL
01
—
G31208
VIVA
AL
Enumeration date
07/06/2006
Last updated
08/20/2019
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