John M. Tierney PA
Physician Assistant in Jacksonville, FL(View on Map)
Full Name
John Michael Tierney PA
NPI Number
1124023445
NPI Type
Individual Provider
Gender
Male
Enumeration Date
06/14/2005
Specialties
(Taxonomies)Licenses
State
Florida
License Number
PA9102882
Contact
Information
Purpose
Mailing
Location
Address
1325 SAN MARCO BLVD STE 200
14540 OLD SAINT AUGUSTINE RD
City
Jacksonville
Jacksonville
State
FL
FL
Postal Code
32207-8566
32258-7418
Country
US
US
Telephone Number
(904) 346-3465
(904) 880-1260
Identifiers
Identifier
292014000
Identifier State
FL
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 11/19/2015