Organization
BAPTIST PRIMARY CARE - INTERNAL MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EARL B MALLY (SR. VICE PRESIDENT)
(904) 376-4275
Entity
Organization
Contact information
Practice address
820 PRUDENTIAL DR, SUITE 314, JACKSONVILLE, FL 32207-8210
(904) 396-2223
Mailing address
8614 BAYMEADOWS WAY, SUITE 100, JACKSONVILLE, FL 32256-8234
(904) 396-0450
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/21/2011
Last updated
07/21/2011
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