Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Fred Carter Ewalt, PA

Individual provider Medical Physician Assistant · NPI 1487629267

Mr. Fred Carter Ewalt, PA is a Medical Physician Assistant in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2080 Child St
Jacksonville, FL 32214-5005
Phone: (904) 542-7765
Fax: (904) 542-7835
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 1462446 (FL)

Record details

NPI number1487629267
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 23, 2006
Last updated in NPPESNovember 10, 2009

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