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Organization

FLAGLER FAMILY MEDICINE P A

Active
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Organization

FLAGLER FAMILY MEDICINE P A

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. RUTH J FAIRCLOTH (ACCOUNTS RECEVIABLE MANAGER)
(904) 826-3469
Entity
Organization

Contact information

Practice address
130 HEALTH PARK BLVD, ST AUGUSTINE, FL 32086-5776
(904) 826-3469
(904) 808-4608
Mailing address
130 HEALTH PARK BLVD, ST AUGUSTINE, FL 32086-5776
(904) 826-3469
(904) 808-4608

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—

Other

Enumeration date
01/19/2007
Last updated
07/23/2008
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