MEDICARE: BAPTIST ENT SPECIALISTS 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
1	207YS0123X	Facial Plastic Surgery Physician
2	207Y00000X	Otolaryngology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467751834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAPTIST ENT SPECIALISTS INC

Provider Business Mailing Address
First Line	:	PO BOX 746656
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6656
Country	:	US
Telephone Number	:	904-202-2092
Fax Number	:	904-376-4075

Provider Business Practice Location Address
First Line	:	3563 PHILIPS HWY STE 101
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-5627
Country	:	US
Telephone Number	:	907-376-3707
Fax Number	:	904-391-5001

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CATHERINE HOLLOWAY
Credential	:
Telephone Number	:	904-202-5378

Provider Enumeration Date	:	03/24/2011
Last Update Date	:	01/12/2026

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Directions to “BAPTIST ENT SPECIALISTS INC ” Practice Location

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