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WESTLEY MICHAEL DURNELL MDR

Independent Duty Corpsman >> Military Health Care Provider >> Other Service Providers

Registrant NPI Number: 1568651321

Individual Registrant:
 WESTLEY MICHAEL DURNELL MDR
Gender: M
Sole Proprietor

Location and contact information for practice:
580 USS MARIANO G. VALLEJO AVE NSSC MEDICAL KINGS BAY, GA 31547 US
Tel: 912-573-2939  Fax: 912-573-4534

Contact information for business:
241 WOODBRIDGE RD  KINGSLAND, GA 31548-3380 US
Tel: 912-573-2939  Fax: 912-573-4534

Registration Information:
NPI: 1568651321
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1710I1002XOther Service Providers
Military Health Care Provider
Independent Duty Corpsman

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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