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Organization
MEMORIAL FAMILY PRACTICE ASSOCIATES, LLC
Active
Organization
MEMORIAL FAMILY PRACTICE ASSOCIATES, LLC
Active
Parent organization
MEMORIAL FAMILY PRACTICE ASSOCIATES, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEMORIAL FAMILY PRACTICE ASSOCIATES, LLC
Authorized official
WILLIAM TEDRICK JOHNSON (VICE PRESIDENT)
(615) 372-3375
Entity
Organization
Contact information
Practice address
11876 ATLANTIC BLVD, JACKSONVILLE, FL 32225-2918
(904) 916-0640
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 372-5426
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
—
NULL
207VX0000X
Obstetrics Physician
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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