Provider Demographics
NPI:1952598963
Name:SAXON FAMILY PRACTICE, PA
Entity type:Organization
Organization Name:SAXON FAMILY PRACTICE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:BLANK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:386-775-1086
Mailing Address - Street 1:932 SAXON BLVD
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8258
Mailing Address - Country:US
Mailing Address - Phone:386-775-1086
Mailing Address - Fax:386-775-8990
Practice Address - Street 1:932 SAXON BLVD
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8258
Practice Address - Country:US
Practice Address - Phone:386-775-1086
Practice Address - Fax:386-775-8990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0S5775207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21717OtherGROUP NUMBER