Individual
MR. DAVID WAYNE FORBIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1715 VILLAGE WAY, ORANGE PARK, FL 32073-5263
(904) 264-8418
(904) 264-9692
Mailing address
680 OHARA RD, MIDDLEBURG, FL 32068-6857
(904) 276-3110
(904) 264-9692
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9101040
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59-3629546
EMPLOYER ID #
FL
Enumeration date
12/30/2006
Last updated
07/08/2007
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