Stanton L Longenecker in Jacksonville - Sports Medicine
Stanton L Longenecker - NPI 1821092271
Stanton L Longenecker is a Sports Medicine in Jacksonville, Florida. Stanton L Longenecker practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Stanton L Longenecker is 1821092271. The last update date is 2019-08-01.
Stanton L Longenecker's current location address is 11945 San Jose Blvd Ste 300, Jacksonville, Florida. You can contact this provider via phone number 9043961725 and fax number 9043964893. The mailing address for Stanton L Longenecker is 11945 San Jose Blvd Ste 300, Jacksonville, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stanton L Longenecker |
|---|---|
| Address | 11945 San Jose Blvd Ste 300, Jacksonville, Florida |
| Phone Number | 9043961725 |
| Fax Number | 9043964893 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1821092271 |
|---|---|
| Provider Enumeration Date | 2005-06-13 |
| Last Updated Date | 2019-08-01 |
Provider Mailing Address Detail
| Address | 11945 San Jose Blvd Ste 300 |
|---|---|
| City | Jacksonville |
| State | Florida (FL) |
| Post Code | 3222316270 |
| Phone Number | 9043961725 |
| Fax Number | 9043964893 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Xx0005X |
| Licence No | ME49077 |
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Definition: An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, train |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 62862000 | FL | -- |
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What is the Stanton L Longenecker's unique identification number?
The Stanton L Longenecker has been assigned the NPI (National Provider Identifier) Number 1821092271 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Can you provide the Stanton L Longenecker's physical address?
The Stanton L Longenecker is physically located at 11945 San Jose Blvd Ste 300, in the city of Jacksonville, FL, with the postal code 3222316270.
What is Stanton L Longenecker's area of expertise and its corresponding taxonomy classification?
The Stanton L Longenecker's field of specialization is Sports Medicine, and it falls under the taxonomy code 207Xx0005X, which categorizes healthcare providers based on their areas of practice.
When was the Stanton L Longenecker's 1821092271 issued?
The Stanton L Longenecker's 1821092271 was issued on 2005-06-13.
As of what date were the Stanton L Longenecker's details last updated?
The information pertaining to the Stanton L Longenecker, including its address, specialty, and other details, was most recently updated on 2019-08-01.