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Gautam Ganguly
General Practice Physician in Orange Park, Florida
NPI 1669849824

Gautam Ganguly is a General Practice Physician based in Orange Park, FL. Gautam Ganguly practices in Orange Park, FL. The NPI Number for Gautam Ganguly is 1669849824 and holds a License No. ACN1448 (Florida).

The current practice location address for Gautam Ganguly is 1542 Kingsley Ave Ste 146, Orange Park, FL and can be reached out via phone at 904-269-2990.

Location: 1542 Kingsley Ave Ste 146, Orange Park, FL, 32073-4547
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1669849824
Provider Name
Gautam Ganguly
Credential
Provider Entity Type
Individual
Gender
Male
Address
1542 Kingsley Ave Ste 146, Orange Park, FL, 32073-4547
Phone Number
904-269-2990
Fax Number
Provider Enumeration Date
08/24/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1542 Kingsley Ave Ste 146
City
Orange Park
State
Florida
Zip
32073-4547
Phone Number
904-269-2990
Fax Number
person
Provider Business Mailing Address Details
Address
1542 Kingsley Ave Ste 146
City
Orange Park
State
Florida
Zip
32073-4547
Phone Number
904-269-2990
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
ACN1448 (Florida)
Definition
Definition to come...
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