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General NPI Number Information
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NPI Number | 1639312283
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Entity Type | Organization
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Legal Business Name | BAPTIST PULMONARY SERVICES INC.
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Dates
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Enumeration Date | 04/13/2009
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Last Update Date | 12/12/2018
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Provider Practice Location Address
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Address Line | 1348 S 18TH ST STE 210
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-4785
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Country | US
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Telephone | 904-261-9108
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Fax | 904-261-9911
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Provider Business Mailing Address
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Address Line | PO BOX 43055
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City | JACKSONVILLE
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State | FL
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Zip | 32203-3055
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Country | US
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Telephone | 904-261-9108
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Fax | 904-261-9911
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MARSHA DONALDSON
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Credential |
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Telephone | 904-376-3707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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