Male or Other

Anthony O. Godboldt MD

Anesthesiology Physician in Jacksonville, FL(View on Map)

Full Name

Anthony O Godboldt MD

NPI Number

1366437782

NPI Type

Individual Provider

Gender

Male

Enumeration Date

09/12/2005

Specialties

(Taxonomies)

Code

207L00000X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

ME41237

Contact
Information

Purpose

Mailing
Location

Address

2165 HERSCHEL ST
1800 BARRS ST

City

Jacksonville
Jacksonville

State

FL
FL

Postal Code

32204-3819
32204-4704

Country

US
US

Telephone Number

(904) 387-4030
(904) 387-4030

Identifiers

Identifier

0336058B
02208

Identifier State

GA
FL

Identifier Issuer

Unknown
BLUE CROSS BLUE SHIELD

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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