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Organization
SOUTHERN MEDICAL CLINIC PA
Active
Organization
SOUTHERN MEDICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN BRIDGEMAN (PRESIDENT)
(904) 259-9377
Entity
Organization
Contact information
Practice address
32 S 5TH ST, MACCLENNY, FL 32063-2302
(904) 259-9377
(904) 259-9949
Mailing address
153 LAURINA ST, JACKSONVILLE, FL 32216-9025
(904) 259-9377
(904) 259-9949
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0047919
FL
Other
Enumeration date
12/27/2006
Last updated
03/13/2012
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