Individual
DR. AUDREY M WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
120 KING ST, JACKSONVILLE, FL 32204-2410
(904) 760-4904
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME81284
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260472800
—
FL
Enumeration date
04/17/2006
Last updated
06/22/2021
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