Basic Information
| Provider Information | |||||||||
| NPI: | 1497287502 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BING | ||||||||
| FirstName: | SHAOXU | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 655 W 8TH ST | ||||||||
| Address2: | BOX FC12 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322096511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043831015 | ||||||||
| FaxNumber: | 9042448172 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 SIGMAN RD NE STE 180 | ||||||||
| Address2: | |||||||||
| City: | CONYERS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300123924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709224024 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2017 | ||||||||
| LastUpdateDate: | 08/08/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208600000X | 91377 | GA | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.