Robert B Dehgan MD PA

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

ME 16903 Issued in FL

Legal business name

ROBERT B DEHGAN MD PA

Practice address

460 Osceola Ave
Jacksonville, FL 32250-4078

Phone

(904) 247-1919

Fax

(904) 246-0301

NPI assigned

Apr 22, 2008

Last updated

Mar 12, 2010By 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

Robert B Dehgan

Title

Ceo/Owner

Phone

(904) 247-1919

Specialties & licenses 1

Addresses

Other identifiers 3

Tax ID family

Robert B Dehgan MD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Robert B Dehgan MD PA

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Palatka, FL
  • NPI 1841463601
  NPD tax ID

Locations

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268352000000",
    "number": "1750555777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 OSCEOLA AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322504078",
            "telephone_number": "904-247-1919",
            "fax_number": "904-246-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 OSCEOLA AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322504078",
            "telephone_number": "904-247-1919",
            "fax_number": "904-246-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT B DEHGAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2010-03-12",
        "status": "A",
        "authorized_official_last_name": "DEHGAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "904-247-1919"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME 16903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "250011286",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049429100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "16803",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Robbins
• Dennis Roberge
• Parnell Eugene Roberson
• Sandra Alden Roberson, P.T.
• Robert a. Sharp, D.M.D., P.a.
• Robert D Mouradian PA
• Robert E Groble MD PA
• Robert F. Travis Jr. D. C. P. a. (Travis Chiropractic Center)
• Robert G Ellison Jr MD P a (Robert G Ellison Jr MD)
• Robert Gerson O.D.

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; 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.