Provider Demographics
NPI:1376539312
Name:CURTIS, RICHARD D (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:D
Last Name:CURTIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11945 SAN JOSE BLVD
Mailing Address - Street 2:BLDG 300
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-1627
Mailing Address - Country:US
Mailing Address - Phone:904-396-1725
Mailing Address - Fax:904-399-1717
Practice Address - Street 1:1715 EAGLE HARBOR PARKWAY
Practice Address - Street 2:SUITE A
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-4323
Practice Address - Country:US
Practice Address - Phone:904-215-2422
Practice Address - Fax:904-215-6122
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME860512086S0105X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001701100Medicaid
FL001701100Medicaid
FL47913YMedicare PIN
6340150001Medicare NSC