Provider Demographics
NPI:1093734782
Name:NYE, JOHN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:NYE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1717 N E ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-6339
Mailing Address - Country:US
Mailing Address - Phone:850-444-4741
Mailing Address - Fax:850-438-7169
Practice Address - Street 1:1717 N E ST
Practice Address - Street 2:SUITE 300
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-6339
Practice Address - Country:US
Practice Address - Phone:850-444-4741
Practice Address - Fax:850-438-7169
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2010-01-08
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Provider Licenses
StateLicense IDTaxonomies
FLME33906208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL038975700Medicaid
FLD21412Medicare UPIN
FL17455Medicare PIN