Provider Demographics
NPI:1023143682
Name:QUINSEY, RICHARD WAYNE (PAC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:WAYNE
Last Name:QUINSEY
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 MICCOSUKEE ROAD
Mailing Address - Street 2:HOSPITALIST GROUP
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-431-4556
Mailing Address - Fax:850-431-6315
Practice Address - Street 1:1300 MICCOSUKEE ROAD
Practice Address - Street 2:HOSPITALISTS GROUP
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-431-4556
Practice Address - Fax:850-431-6315
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104064363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1023143682Medicaid
FLAC970XMedicare Oscar/Certification