Ingram, Jeremy David

Ingram, Jeremy David is an individual health care provider with primary practice located at 2776 Cleveland Ave , Fort Myers FL 33901-5864. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Ingram, Jeremy David can be contacted via phone (239) 343-2606.

Contact Information

Primary practice address
2776 Cleveland Ave Fort Myers FL 33901-5864
Phone: (239) 343-2606
Fax: (239) 343-3695
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X OS10697 Florida

Profile Details

NPI number 1396946430
LBN Legal business name Ingram, Jeremy David
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2007
Last updated Mar 25th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396946430 NPPES
Florida Other 148MK BLUE CROSS PROVIDER NUMBER
Florida MEDICAID 002279300 BLUE CROSS PROVIDER NUMBER

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