W.B. STEWART TIGERS ATHLETICS BOOSTERS NPI 1841794682

NPI Information

W.B. STEWART TIGERS ATHLETICS BOOSTERS is an adolescent medicine pediatrics in Jacksonville, FL. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. W.B. STEWART TIGERS ATHLETICS BOOSTERS NPI is 1841794682. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Ewc Sports Medicine.

The provider's business location address is:

1658 KINGS RD
JACKSONVILLE, FL
ZIP 32209-167
Phone: (972) 367-4845

The provider's authorized official is Mouzon Bass .
The authorized official title is Agent and has the following contact phone number (972) 367-4845.

The enumeration date for this NPI number is 3/19/2018 and was last updated on 3/19/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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