Individual
GEORGE MOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4652 MILL STATION PLACE, JACKSONVILLE, FL 32257
(229) 353-6208
(229) 353-7722
Mailing address
4652 MILL STATION PLACE, JACKSONVILLE, FL 32257
(229) 353-6208
(229) 353-7722
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28182249A
IN
367500000X
Certified Registered Nurse Anesthetist
AP04439
LA
367500000X
Certified Registered Nurse Anesthetist
RN080513
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000610491
ANTHEM PROVIDER NUMBER
IN
05
—
009943111
—
AL
05
—
1014249
—
LA
05
—
200936900
—
IN
05
—
475163752A
—
GA
01
—
P00413422
RAILROAD MEDICARE
GA
Enumeration date
11/01/2006
Last updated
02/11/2010
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