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NPI Code Detail

MEDICARE: BAPTIST PRIMARY CARE, INC.

MEDICARE: BAPTIST PRIMARY CARE, INC.
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianFL

General Provider Information

NPI Number : 1538566542
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAPTIST PRIMARY CARE, INC.
Provider Business Mailing Address
First Line : PO BOX 45443
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84145-0443
Country : US
Telephone Number : 904-202-1032
Fax Number : 904-376-4107
Provider Business Practice Location Address
First Line : 400 COLONNADE DR STE 160
Second Line :
City : PONTE VEDRA
State : FL
Zip : 32081-6236
Country : US
Telephone Number : 904-824-1020
Fax Number : 904-390-7503
Authorized Official
Title or Position : VICE PRESIDENT
Name : MARSHA DONALDSON
Credential :
Telephone Number : 904-376-3703
Provider Enumeration Date : 11/20/2014
Last Update Date : 11/22/2023

Similar Medicare Providers

1518969575 — DR. ANGELA KAY STAPLETON-MACKENZIE M.D.
Practice Location Address:
400 COLONNADE DR STE 160
PONTE VEDRA, FL
32081-6236
Practice Phone: 904-824-1020
Practice Fax: 904-390-7503
1215915574 — JOSHUA M HARRISON M.D.
Practice Location Address:
400 COLONNADE DR STE 160
PONTE VEDRA, FL
32081-6236
Practice Phone: 904-824-1020
Practice Fax: 904-390-7503
1750353579 — JAMES D MOORE MD
Practice Location Address:
400 COLONNADE DR STE 160
PONTE VEDRA, FL
32081-6236
Practice Phone: 904-248-1020
Practice Fax: 904-824-5333
1497098586 — MRS. LAURA T LOGAN APRN
Practice Location Address:
400 COLONNADE DR STE 160
PONTE VEDRA, FL
32081-6236
Practice Phone: 904-824-1020
Practice Fax: 904-390-7503
1750794616 — ROBERT KAWA D.O.
Practice Location Address:
400 COLONNADE DR STE 160
PONTE VEDRA, FL
32081-6236
Practice Phone: 904-824-1020
Practice Fax: 904-824-5333
1568956456 — MR. ANDREW LOURENS APRN
Practice Location Address:
400 COLONNADE DR STE 160
PONTE VEDRA, FL
32081-6236
Practice Phone: 904-824-1020
Practice Fax: 904-390-7503

Directions to “BAPTIST PRIMARY CARE, INC. ” Practice Location

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