Id Consults and Services, PA

NPI #1043551468 in Key West, Florida

Provider Information

NPI Number: 1043551468
Entity Type: Organization
Organization Name: Id Consults and Services, PA
Primary Specialty: Internal Medicine - Infectious Disease
Enumeration Date: Mar 11, 2013
Last Updated: Oct 17, 2013

Practice Location

Address: 3142 NORTHSIDE DR
Address 2: SUITE 101
City: Key West
State: Florida
ZIP Code: 33040-8012
Phone: (305) 615-3300

Authorized Official

Name: MR. DARRYL WALLACE
Title: BUSINESS MANAGER
Phone: (770) 977-5056

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine - Infectious Disease — Infectious Disease	207RI0200X	Primary

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DR. Mark Eric Whiteside, M.D.	Internal Medicine - Infectious Disease	Key West	AI Deep Dive
Jerry Jay Jackson, MD	Internal Medicine - Infectious Disease	Key West	AI Deep Dive
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Organizations

Provider Name	Specialty	City
Id Consults and Services, PA Part of Id Consults and Services, PA	Internal Medicine - Infectious Disease	Key West	AI Deep Dive

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