# BRANCH MEDICAL CLINIC JACKSONVILLE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NAVAL HOSPITAL JACKSONVILLE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104331065
- **Legal business name:** NAVAL HOSPITAL JACKSONVILLE
- **Authorized official:** WILLIAM M CONDON (BUMED UBO)
- **Authorized official phone:** (240) 401-3643

## Contact information

- **Practice address:** 964 AJAX ST, JACKSONVILLE, FL 32214-0001
- **Practice address phone:** (904) 546-7094
- **Mailing address:** 2080 CHILD ST, JACKSONVILLE, FL 32214-5005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 12/13/2017
- **Last updated:** 12/13/2017