Stark, John B
Stark, John B is an individual health care provider with primary practice located at One Orthopaedic Place , St. Augustine FL 32086-4202. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Hand Surgery. Allopathic & Osteopathic Physicians / Hand Surgery is his primary health care specialty. Stark, John B can be contacted via phone (904) 825-0540.Contact Information
Primary practice address
One Orthopaedic Place
St. Augustine FL 32086-4202
Phone: (904) 825-0540
Fax: (904) 209-1055
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | ME96534 | Florida |
| Allopathic & Osteopathic Physicians / Hand Surgery | 207XS0106X | ME96534 | Florida |
Profile Details
| NPI number | 1922087618 |
|---|---|
| LBN Legal business name | Stark, John B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 11th, 2006 |
| Last updated | Jul 8th, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922087618 | NPPES |
| Illinois | MEDICAID | 036112556 | |
| Illinois | Other | 1174540001 | |
| Illinois | Other | 1174540001 |
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