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NPI Code Detail

MEDICARE: FAMILY PRACTICE ASSOCIATES OF JACKSONVILLE

MEDICARE: FAMILY PRACTICE ASSOCIATES OF JACKSONVILLE
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 Physician

General Provider Information

NPI Number : 1558353854
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY PRACTICE ASSOCIATES OF JACKSONVILLE
Provider Business Mailing Address
First Line : 6111 BEACH BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-2751
Country : US
Telephone Number : 904-739-1140
Fax Number : 904-722-1674
Provider Business Practice Location Address
First Line : 6111 BEACH BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-2751
Country : US
Telephone Number : 904-739-1140
Fax Number : 904-722-1674
Authorized Official
Title or Position : PRESIDENT
Name : STEPHEN J CLARK
Credential : M.D.
Telephone Number : 904-739-1140
Provider Enumeration Date : 08/22/2005
Last Update Date : 08/22/2020

Similar Medicare Providers

1104826593 — STEPHEN CLARK M.D.
Practice Location Address:
6111 BEACH BLVD
JACKSONVILLE, FL
32216-2751
Practice Phone: 904-739-1140
Practice Fax: 904-722-1674
1710973268 — MR. DENVER D NUTTER M.D.
Practice Location Address:
6111 BEACH BLVD
JACKSONVILLE, FL
32216-2751
Practice Phone: 904-739-1140
Practice Fax: 904-722-9578
1073571550 — CHARLOTTE COTTON M.D.
Practice Location Address:
6111 BEACH BLVD
JACKSONVILLE, FL
32216-2751
Practice Phone: 904-739-1140
Practice Fax: 904-722-9578
1265482673 — MRS. JANA B ROBINSON ARNP
Practice Location Address:
6111 BEACH BLVD
JACKSONVILLE, FL
32216-2751
Practice Phone: 904-739-1140
Practice Fax: 904-722-9578
1790227411 — AUSTIN PHILLIPS
Practice Location Address:
2751 JACKSONVILLE RD
BELLEFONTE, PA
16823-7810
Practice Phone: 814-574-4554
Practice Fax:
1487425047 — JONATHAN REX
Practice Location Address:
1081 MIMOSA COVE CT W
JACKSONVILLE, FL
32233-2751
Practice Phone: 260-255-6447
Practice Fax:

Directions to “FAMILY PRACTICE ASSOCIATES OF JACKSONVILLE ” Practice Location

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