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General NPI Number Information
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NPI Number | 1558457341
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Entity Type | Organization
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Legal Business Name | FIRST COAST FAMILY MEDICINE PA
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 9130 RG SKINNER PARKWAY
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City | JACKSONVILLE
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State | FL
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Zip | 32256
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Country | US
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Telephone | 904-538-0950
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Fax | 904-538-0952
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Provider Business Mailing Address
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Address Line | 9130 RG SKINNER PKWY
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City | JACKSONVILLE
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State | FL
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Zip | 32256
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Country | US
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Telephone | 904-538-0950
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Fax | 904-538-0952
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Authorized Official
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Title or Position | OWNER
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Name | DR. TERRY D HASHEY
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Credential | DO
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Telephone | 904-538-0950
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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 | OS 9368
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License Number State | FL
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