John R Degraw, M.D.
Family Medicine in Crystal River, FL. Individual provider (NPI-1).
NPI number1992736672
StatusActive
Last updated in NPPESOct 1, 2020
Details
- NPI
- 1992736672
- Entity type
- Individual (NPI-1)
- Name
- John R Degraw
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 5, 2006
- Certification date
- Oct 1, 2020
- Last updated
- Oct 1, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | ME0048978 | FL | Yes |
| 261QR1300X | Clinic/Center, Rural Health | 108911 | FL |
Other names
- Johnnie R Degraw (Professional Name)
Practice location
5915 W Gulf To Lake HwyCrystal River, FL 34429-7565
Phone 352-794-3872 · Fax 352-794-3876
Mailing address
5915 W Gulf To Lake HwyCrystal River, FL 34429-7565
Phone 352-794-3872 · Fax 352-794-3876
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