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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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1558593996
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAPTIST PRIMARY CARE INC
Provider Business Mailing Address
First Line : PO BOX 45443
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84145-0443
Country : US
Telephone Number : 904-202-1032
Fax Number : 904-376-4107
Provider Business Practice Location Address
First Line : 2014 UNIVERSITY BLVD W
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32217-2016
Country : US
Telephone Number : 904-733-9211
Fax Number : 904-733-9388
Authorized Official
Title or Position : VICE PRESIDENT
Name : MARSHA DONALDSON
Credential :
Telephone Number : 904-376-3703
Provider Enumeration Date : 08/19/2009
Last Update Date : 12/12/2018

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Directions to “BAPTIST PRIMARY CARE INC ” Practice Location

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