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General NPI Number Information
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NPI Number | 1194962142
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Entity Type | Organization
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Legal Business Name | JACKSONVILLE URGENT CARE LLC
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 1126 UNIVERSITY BLVD N
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City | JACKSONVILLE
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State | FL
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Zip | 32211-8850
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Country | US
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Telephone | 832-651-0323
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Fax |
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Provider Business Mailing Address
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Address Line | 1126 UNIVERSITY BLVD N
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City | JACKSONVILLE
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State | FL
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Zip | 32211-8850
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Country | US
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Telephone | 832-651-0323
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHIDI UCHE
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Credential | MD
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Telephone | 832-651-0323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME97989
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License Number State | FL
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