Degraw, John R
Degraw, John R is an sole proprietor health care provider with primary practice located at 5915 W Gulf To Lake Hwy , Crystal River FL 34429-7565. He recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Rural Health, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Degraw, John R can be contacted via phone (352) 794-3872.Contact Information
Primary practice address
5915 W Gulf To Lake Hwy
Crystal River FL 34429-7565
Phone: (352) 794-3872
Fax: (352) 794-3876
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Rural Health | 261QR1300X | 108911 | Florida |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME0048978 | Florida |
Profile Details
| NPI number | 1992736672 |
|---|---|
| LBN Legal business name | Degraw, John R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Oct 1st, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992736672 | NPPES |
| Florida | Other | 02120A | BCBS |
| Florida | Other | 208262765 | BCBS |
| Florida | Other | 6450130001 | BCBS |
| Florida | Other | P00473712 | BCBS |
| Florida | MEDICAID | 274574700 | BCBS |
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