How To Use This Guide/Order & Information Request Form
HOW TO USE THIS GUIDE Locate your physician’s information by their name and specialty category.
Locate your physician in the Alphabetical Listings of Physicians & Surgeons.
3
118
1
Degree
DOE II, JOHN, MD NPI: 1234567890 National Provider Identifier (NPI) DOE & ASSOCIATES Business Name 1234 Anywhere Dr. E., Ste. 123 Location 1 Gainesville, FL 32601 352-555-1234 Fax: 352-555-2345 Location 2 5678 Somewhere Rd., Ste. 23 Gainesville, FL 32602 352-555-3456 Fax: 352-555-4567 www.doejohn.com Website ➤ see our ad page 120
2
Doe II, John, MD.........................118
Physician’s Name
Reference to Advertisement
Go to the page number that is listed in reference to your physician.
North Central Florida Healthcare Guide™
ORDER & INFORMATION REQUEST FORM NORTH CENTRAL FLORIDA HEALTHCARE GUIDE IS COMPLIMENTARY TO HEALTHCARE PROVIDERS (SHIPPING & HANDLING NOT INCLUDED)
Contact Name
QUANTITY REQUESTED
Company Name
TOTAL
$49.95*
Address
Sales Tax:
N/A
Shipping/Handling:
City, State ZIP Phone
PRICE PER COPY
Fax
Total: *$5.95 SHIPPING PER COPY CALL FOR ORDERS GREATER THAN 3 COPIES Mail or Fax to:
Payment Options:
Heritage Publishing, Inc. 9250 Baymeadows Rd., Ste. 460 Jacksonville, FL 32256 Phone: 904-296-1304 • Fax: 904-296-8522
Credit Card Number: Expiration Date:
YES!
Check Number: Make Checks Payable To: Heritage Publishing, Inc.
I would like to receive information on the following NCFHCG opportunities
Database Listing
Advertising
Or go to http://heritagepublishinginc.com/request Heritage Publishing, Inc. © 2021
17
