person
Thomas Kotheimer, PA
Medical Physician Assistant in Orange Park, Florida
NPI 1235126053

Thomas Kotheimer is a Medical Physician Assistant based in Jacksonville, FL and is specialized in Medical. Thomas Kotheimer practices in Orange Park, FL and has the professional credentials of PA. The NPI Number for Thomas Kotheimer is 1235126053 and holds a License No. PA 2559 (Florida).

The current practice location address for Thomas Kotheimer is 2161 Kingsley Ave, Orange Park, FL and can be reached out via phone at 904-727-3139 and via fax at 904-276-7434.

Location: 2161 Kingsley Ave, Orange Park, FL, 32256-1348
person
Provider Profile Details
NPI Number
1235126053
Provider Name
Thomas Kotheimer
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
2161 Kingsley Ave, Orange Park, FL, 32256-1348
Phone Number
904-727-3139
Fax Number
904-276-7434
Provider Enumeration Date
10/06/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
291828500 05 FL
Y03PU 01 FL BCBSFL
institution
Provider Business Practice Location Address Details
Address
2161 Kingsley Ave
City
State
Zip
32073-5113
Phone Number
904-727-3139
Fax Number
904-276-7434
person
Provider Business Mailing Address Details
Address
2161 Kingsley Ave
City
State
Zip
32073-5113
Phone Number
904-727-3139
Fax Number
904-276-7434
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA 2559 (Florida)
Definition
Definition to come...
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