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Organization
QHG OF JACKSONVILLE INC
Active
Organization
QHG OF JACKSONVILLE INC
Active
Parent organization
QHG OF JACKSONVILLE INC
Other names
Jacksonville Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
QHG OF JACKSONVILLE INC
Authorized official
DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(877) 892-9813
Entity
Organization
Contact information
Practice address
1701 PELHAM RD S, JACKSONVILLE, AL 36265-3353
(256) 435-4970
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
09/20/2006
Last updated
02/08/2008
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