Putnam E N T PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0050554 Issued in FL

Legal business name

PUTNAM E N T PA

Practice address

320 Zeagler Dr
Ste 1
Palatka, FL 32177-6851

Phone

(386) 325-1565

Fax

(386) 325-1571

NPI assigned

Sep 15, 2007

Organization subpart

No

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

Authorized official

Name

Glenwood Antonio Charles, MD

Title

President

Phone

(386) 325-1565

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Uma Eyyunni, MD

  • Otolaryngology Physician
  • St Augustine, FL
  • NPI 1821192352
  NPD (past)

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

{
    "created_epoch": "1189814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238630400000",
    "number": "1467648279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 ZEAGLER DR",
            "address_2": "STE 1",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321776851",
            "telephone_number": "386-325-1565",
            "fax_number": "386-325-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 ZEAGLER DR",
            "address_2": "STE 1",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321776851",
            "telephone_number": "386-325-1565",
            "fax_number": "386-325-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTNAM E N T PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-15",
        "last_updated": "2009-04-02",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "GLENWOOD",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-325-1565",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0050554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064059000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Putnam County Public School District
• Putnam County Public School District
• Putnam County Public School District
• Putnam County Public School District
• Putnam Diagnostic, Inc.
• Putnam Emergency Group LLC
• Putnam Family Care, Inc.
• Putnam Heart Center PA
• Putnam Imaging Center, LLC
• Putnam Neurology Group, Inc.

• Specialist in Palatka, FL
• Providers in Palatka, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; 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.