Southeast Gynecologic Oncology Associates PA

Primary specialty

Gynecologic Oncology PhysicianTaxonomy code 207VX0201X

Legal business name

SOUTHEAST GYNECOLOGIC ONCOLOGY ASSOCIATES PA

Practice address

915 W Monroe St
#300
Jacksonville, FL 32204-1149

Phone

(904) 389-3993

Fax

(904) 389-3994

NPI assigned

May 5, 2006

Last updated

Jul 1, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Brenda Davis

Title

Administrator

Phone

(904) 389-3993

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen Leslie Buckley, M.D.

  • Gynecologic Oncology Physician
  • Jacksonville, FL
  • NPI 1396794681
  NPD (past)
• Debra L Motycka, PA-C

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1558375543
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1417905993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST",
            "address_2": "#300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041149",
            "telephone_number": "904-389-3993",
            "fax_number": "904-389-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST",
            "address_2": "#300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041149",
            "telephone_number": "904-389-3993",
            "fax_number": "904-389-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST GYNECOLOGIC ONCOLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-389-3993",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Nicole South
• Matthew Travis South
• Cathleen Helena Southall, ARNP
• Southbrdge Health and Wellness LLC
• Southeast Anesthesia Consultants, LLC
• Southeast Orthopedic Specialists, Inc
• Southeast Orthopedic Specialists, Inc
• Southeast Orthopedic Specialists, Inc
• Southeast Orthopedic Specialists, Inc
• Southeast Orthopedic Specialists, Inc

• Gynecologic Oncology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Gynecologic Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.