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NPI Code Detail

MEDICARE: BAPTIST PRIMARY CARE INC

MEDICARE: BAPTIST PRIMARY CARE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1275398216
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAPTIST PRIMARY CARE INC
Provider Business Mailing Address
First Line : PO BOX 746638
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6638
Country : US
Telephone Number : 904-202-1032
Fax Number : 904-376-4107
Provider Business Practice Location Address
First Line : 2839 HENLEY RD
Second Line :
City : GREEN COVE SPRINGS
State : FL
Zip : 32043-8616
Country : US
Telephone Number : 904-376-4950
Fax Number : 904-618-2183
Authorized Official
Title or Position : VICE PRESIDENT
Name : MARSHA DONALDSON
Credential :
Telephone Number : 904-334-7627
Provider Enumeration Date : 02/19/2024
Last Update Date : 04/18/2024

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Directions to “BAPTIST PRIMARY CARE INC ” Practice Location

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