TIMOTHY L WYATT MD PA
Osteopathic Medicine at Park St, Jacksonville, FL

License number
Florida ME64092
Category
Osteopathic Medicine
Type
Endocrinology, Diabetes & Metabolism
Owner
Name: DR. TIMOTHY LESTER WYATT MD
Title: PRESIDENT
Phone: (904) 981-9959
Address
Address
2360A Park St, Jacksonville, FL 32204
National Provider ID: 1528374741
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Timothy L. Wyatt, M.D., PA

Jacksonville, FL

Industry:
Medical Doctor's Office
Registration:
Sep 30, 1998
Addresses:
2360 Park St, Jacksonville, FL 32204
4651 Wadham Ln, Jacksonville, FL 32210
State ID:
P98000084262
Business type:
Domestic for Profit Corporation
President, Treasurer, Secretary, Director, Vice President:
Timothy L. Wyatt (President, Treasurer, Secretary, Director, Vice President)

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