Provider Demographics
NPI:1568499424
Name:ALBERT, GEORGE LOUIS
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:LOUIS
Last Name:ALBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:LOUIS
Other - Last Name:ALBERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 8887
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32239-0887
Mailing Address - Country:US
Mailing Address - Phone:904-237-5239
Mailing Address - Fax:904-744-0018
Practice Address - Street 1:5913 NORMANDY BLVD
Practice Address - Street 2:13
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-6269
Practice Address - Country:US
Practice Address - Phone:904-786-2781
Practice Address - Fax:904-786-9954
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8396111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor