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General NPI Number Information
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NPI Number | 1841674314
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Entity Type | Organization
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Legal Business Name | PHYSICIANS GROUP SERVICES PA
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 421 KINGSLEY AVE STE 300
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City | ORANGE PARK
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State | FL
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Zip | 32073-4898
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Country | US
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Telephone | 904-621-0643
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Fax | 904-621-0644
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Provider Business Mailing Address
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Address Line | 705 WELLS RD STE 300
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City | ORANGE PARK
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State | FL
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Zip | 32073-2982
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Country | US
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Telephone | 904-282-6331
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Fax | 904-619-1080
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Authorized Official
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Title or Position | CEO
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Name | ANDREW T CHRISTMAN
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Credential |
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Telephone | 941-685-7688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics 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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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