Basic Information
| Provider Information | |||||||||
| NPI: | 1225003585 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAPPAN | ||||||||
| FirstName: | JAYSON | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3958 LEATHERWOOD DR | ||||||||
| Address2: | |||||||||
| City: | ORANGE PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 320655528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9044062405 | ||||||||
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| Practice Location | |||||||||
| Address1: | NAVAL HOSPITAL JACKSONVILLE | ||||||||
| Address2: | 2080 CHILD STREET | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322140001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9045423500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2006 | ||||||||
| LastUpdateDate: | 02/20/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083A0100X | 0101233847 | VA | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Aerospace Medicine |
No ID Information.