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Individual

DR. DARRIN LAMAR WILLINGHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME77716
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020052997
RAILROAD MEDICARE
FL
05
264675700
FL
01
46258
BLUECROSS/BLUESHIELD
FL
Enumeration date
10/15/2005
Last updated
11/06/2012
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