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Organization

JACKSONVILLE PEDIATRICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RANDOLPH EDENS THORNTON M.D. (SENIOR PHYSICIAN)
(904) 389-4140
Entity
Organization

Contact information

Practice address
2606 PARK ST, JACKSONVILLE, FL 32204-4520
(904) 388-4646
(904) 388-9071
Mailing address
2606 PARK ST, JACKSONVILLE, FL 32204-4520
(904) 388-4646
(904) 388-9071

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
FL

Other

Enumeration date
02/26/2007
Last updated
07/21/2022
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