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	207Y00000X	Otolaryngology Physician		FL

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	:	1700265998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAPTIST ENT SPECIALISTS INC

Provider Business Mailing Address
First Line	:	PO BOX 40767
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32203-0767
Country	:	US
Telephone Number	:	904-376-3707
Fax Number	:	904-391-5001

Provider Business Practice Location Address
First Line	:	1747 BAPTIST CLAY RD
Second Line	:	SUITE 360
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-8502
Country	:	US
Telephone Number	:	904-592-1068
Fax Number	:	904-541-4728

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CATHERINE GRAHAM
Credential	:
Telephone Number	:	904-202-5370

Provider Enumeration Date	:	05/21/2015
Last Update Date	:	02/01/2017

Similar Medicare Providers

1285627497 — PAUL A WALKER M.D.
Practice Location Address:

1747 BAPTIST CLAY DR , SUITE 230
FLEMING ISLAND, FL
32003-8502

Practice Phone: 904-592-1068
Practice Fax: 904-541-4728

1053352864 — DIAN S TRENT ARNP
Practice Location Address:

1747 BAPTIST CLAY RD , SUITE 340
FLEMING ISLAND, FL
32003-8502

Practice Phone: 904-264-1204
Practice Fax: 904-264-1227

1285868141 — MISS CAROL A VISCONTI
Practice Location Address:

1747 BAPTIST CLAY DR , SUITE 350
FLEMING ISLAND, FL
32003-8502

Practice Phone: 904-376-3800
Practice Fax: 904-396-8966

1285961763 — JACKSONVILLE ORTHOPAEDIC INSTITUTE INC
Practice Location Address:

1747 BAPTIST CLAY DR , SUITE 210
FLEMING ISLAND, FL
32003-8502

Practice Phone: 904-621-0396
Practice Fax: 904-621-0397

1528301090 — CURTIS LAWRENCE STORM M.D.
Practice Location Address:

1747 BAPTIST CLAY DR , SUITE 340
FLEMING ISLAND, FL
32003-8502

Practice Phone: 904-264-4405
Practice Fax: 904-391-5380

1083019772 — BAPTIST NEUROLOGY INC
Practice Location Address:

1747 BAPTIST CLAY DR, SUITE 310 , ATTN: CREDENTIALING DEPARTMENT
FLEMING ISLAND, FL
32003-8502

Practice Phone: 904-224-8090
Practice Fax: 904-224-8097

Directions to “BAPTIST ENT SPECIALISTS INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.