Mabry Jr, George Otto

Mabry Jr, George Otto is an sole proprietor health care provider with primary practice located at 2194 Hwy A1A Suite 108, Indian Harbour Beach FL 32937-4930. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Radiology. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is his primary health care specialty. Mabry Jr, George Otto can be contacted via phone (321) 777-9559.

Contact Information

Primary practice address
2194 Hwy A1A Suite 108 Indian Harbour Beach FL 32937-4930
Phone: (321) 777-9559
Fax: (321) 777-9558
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X PO2788 Florida
Podiatric Medicine & Surgery Service Providers / Radiology 213ER0200X JR3863700 Florida

Profile Details

NPI number 1023079688
LBN Legal business name Mabry Jr, George Otto
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 31st, 2006
Last updated Dec 27th, 2016 - about 8 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 1023079688 NPPES
Florida Other 65612 BCBS ID
Florida Other 2900719 BCBS ID
Florida Other 7781081 BCBS ID
Florida MEDICAID 340672500 BCBS ID
Florida Other 0380220001 BCBS ID

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