Provider Demographics
NPI:1306821236
Name:AHLGRIM, JOEL ALAN (DO)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ALAN
Last Name:AHLGRIM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 746638
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6638
Mailing Address - Country:US
Mailing Address - Phone:904-202-2092
Mailing Address - Fax:904-376-4075
Practice Address - Street 1:400 COLONNADE DR STE 230
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32081-6237
Practice Address - Country:US
Practice Address - Phone:904-376-3970
Practice Address - Fax:904-376-3435
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2025-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS20124207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine