Tierney, John Michael

Tierney, John Michael is an individual health care provider with primary practice located at 14540 Old Saint Augustine Rd Suite 2201, Jacksonville FL 32258-7418. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Tierney, John Michael can be contacted via phone (904) 880-1260.

Contact Information

Primary practice address
14540 Old Saint Augustine Rd Suite 2201 Jacksonville FL 32258-7418
Phone: (904) 880-1260
Fax: (904) 880-1210
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9102882 Florida

Profile Details

NPI number 1124023445
LBN Legal business name Tierney, John Michael
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Nov 19th, 2015 - about 9 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 1124023445 NPPES
Florida MEDICAID 292014000

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