Mr. Fred C. Ewalt PA
Medical Physician Assistant in Jacksonville, FL(View on Map)
Full Name
Mr. Fred Carter Ewalt PA
NPI Number
1487629267
NPI Type
Individual Provider
Gender
Male
Enumeration Date
02/23/2006
Specialties
(Taxonomies)Licenses
State
Florida
License Number
1462446
Contact
Information
Purpose
Mailing
Location
Address
2080 CHILD ST
2080 CHILD ST
City
Jacksonville
Jacksonville
State
FL
FL
Postal Code
32214-5005
32214-5005
Country
US
US
Telephone Number
(904) 542-7765
(904) 542-7765
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 11/10/2009