Organization
BAPTIST MD ANDERSON CANCER PHYSICIANS INC
Active
Other names
Baptist MD Anderson Cancer Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
LEEANN MENGEL (ADMINISTRATOR)
(904) 202-7300
Entity
Organization
Contact information
Practice address
14540 OLD SAINT AUGUSTINE RD, SUITE 2593, JACKSONVILLE, FL 32258-7418
(904) 389-3993
(904) 389-3994
Mailing address
PO BOX 746654, ATLANTA, GA 30374-6654
(904) 202-2092
(904) 393-7603
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009942200
—
FL
01
—
DU3570
RR MEDICARE
FL
Enumeration date
02/20/2017
Last updated
04/10/2023
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