Active NPI
Putnam Diagnostic, Inc.
- Clinical Medical Laboratory
- Palatka, FL
National Provider Identifier
1841433018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 800024088
- Legal business name
- PUTNAM DIAGNOSTIC, INC.
- Practice address
- 6101 Crill Ave
Palatka, FL 32177-3875 - Phone
- (386) 326-1225
- NPI assigned
- Apr 16, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jerry Jacobson, MD
- Title
- VP
- Phone
- (386) 326-1225
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 800024088 | FL | Primary |
Addresses
Primary practice location
6101 Crill Ave
Palatka, FL 32177-3875
Mailing address
PO Box 55
Palatka, FL 32178-0055
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239840000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1239840000000",
"number": "1841433018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 55",
"city": "PALATKA",
"state": "FL",
"postal_code": "321780055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6101 CRILL AVE",
"city": "PALATKA",
"state": "FL",
"postal_code": "321773875",
"telephone_number": "386-326-1225"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PUTNAM DIAGNOSTIC, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2009-04-16",
"last_updated": "2009-04-16",
"status": "A",
"authorized_official_last_name": "JACOBSON",
"authorized_official_first_name": "JERRY",
"authorized_official_title_or_position": "VP",
"authorized_official_telephone_number": "386-326-1225",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "FL",
"license": "800024088",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palatka, FL
- Putnam County Public School District
- Putnam County Public School District
- Putnam County Public School District
- Putnam County Public School District
- Putnam County Public School District
- Putnam E N T PA
- Putnam Emergency Group LLC
- Putnam Family Care, Inc.
- Putnam Heart Center PA
- Putnam Imaging Center, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.