Caccam, Ian S

Caccam, Ian S is an individual health care provider with primary practice located at 800 Prudential Dr , Jacksonville FL 32207-8202. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Caccam, Ian S can be contacted via phone (904) 202-2000.

Contact Information

Primary practice address
800 Prudential Dr Jacksonville FL 32207-8202
Phone: (904) 202-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X ME0087735 Florida

Profile Details

NPI number 1699765131
LBN Legal business name Caccam, Ian S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated May 21st, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699765131 NPPES
Florida Other 79023 BCBS
Florida MEDICAID 340389100 BCBS
Florida MEDICAID 000970219C BCBS

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