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Organization
MEMORIAL FAMILY PRACTICE ASSOCIATES
Active
Organization
MEMORIAL FAMILY PRACTICE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA BUCKINGHAM (ADMINISTRATOR)
(904) 306-8067
Entity
Organization
Contact information
Practice address
3546 ST JOHNS BLUFF ROAD SOUTH, SUITE 108, JACKSONVILLE, FL 32224
(904) 306-8067
Mailing address
PO BOX 277272, ATLANTA, GA 30384-7272
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/11/2006
Last updated
07/26/2007
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