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NPI Code Detail

MEDICARE: JENNIFER MARIE SIDEY MD

MEDICARE:   JENNIFER MARIE SIDEY  MD
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 PhysicianME145451FL

Other Identifiers

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

General Provider Information

NPI Number : 1518496975
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MARIE SIDEY MD
Provider Business Mailing Address
First Line : 705 WELLS RD STE 300
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-2982
Country : US
Telephone Number : 904-282-6331
Fax Number : 904-619-1080
Provider Business Practice Location Address
First Line : 1689 EAGLE HARBOR PKWY STE A
Second Line :
City : FLEMING ISLAND
State : FL
Zip : 32003-4817
Country : US
Telephone Number : 904-269-1366
Fax Number : 904-264-9750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2017
Last Update Date : 09/16/2022

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Directions to “ JENNIFER MARIE SIDEY MD” Practice Location

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