Healthcare Provider Details

I. General information

NPI: 1932682986
Provider Name (Legal Business Name): PHYSICIANS GROUP SERVICES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2018
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 KINGSLEY AVE STE 400
ORANGE PARK FL
32073-4898
US

IV. Provider business mailing address

705 WELLS RD STE 300
ORANGE PARK FL
32073-2982
US

V. Phone/Fax

Practice location:
  • Phone: 904-265-0470
  • Fax: 904-223-3949
Mailing address:
  • Phone: 904-282-6331
  • Fax: 904-619-1080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANDREW T CHRISTMAN
Title or Position: CEO
Credential:
Phone: 941-685-7688