Unknown Individual – Internal Medicine Physician, NPI 1538185467
Internal Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
1921 Alice St
Waycross, GA 315016200
Phone: (912) 283-5616
Type: Location
615, Pendleton Street, Waycross, Ware County, Georgia, 31501, United States
WAYCROSS, GA 315014724
Phone: (912) 385-9994
Type: Location
4015, Belfort Road, Jacksonville, Duval County, Florida, 32216, United States
JACKSONVILLE, FL 322163623
Phone: (904) 296-5691
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 31501)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| Family Practice | FL | |
| - | FL | |
| Family Practice | FL | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | FL | |
| Physician Assistant | FL | |
| Nurse Practitioner | FL |
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