MEDICARE: BAPTIST ENT SPECIALISTS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207K00000X	Allergy & Immunology Physician
2	231H00000X	Audiologist
3	207Y00000X	Otolaryngology Physician

General Provider Information

NPI Number	:	1467741264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAPTIST ENT SPECIALISTS INC

Provider Business Mailing Address
First Line	:	PO BOX 41516
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32203-1516
Country	:	US
Telephone Number	:	904-202-5111
Fax Number	:	904-391-5836

Provider Business Practice Location Address
First Line	:	1660 PRUDENTIAL DR STE 320
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-8197
Country	:	US
Telephone Number	:	904-376-3707
Fax Number	:	904-391-5001

Authorized Official
Title or Position	:	DIRECTOR
Name	:	CATHERINE HOLLOWAY
Credential	:
Telephone Number	:	904-202-5378

Provider Enumeration Date	:	04/01/2011
Last Update Date	:	03/03/2021

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Directions to “BAPTIST ENT SPECIALISTS INC ” Practice Location

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