NPI 1104060607
James Andrew Jack, IDMT
Practice location
- Address
- 113 Lielmanis Ave, Hurlburt Field, FL 32544-5604
- Phone
- (850) 881-2337
- Mailing address
- 113 Lielmanis Ave, Hurlburt Field, FL 32544-5613
Registered specialties
Independent Duty Medical Technicians
Primary
Registry record
- NPI
- 1104060607
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 28 Apr 2009
- Record last updated
- 6 Jan 2012
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.