Organization
YERGIN PULMONARY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE M YERGIN M.D. (PRESIDENT)
(904) 396-0300
Entity
Organization
Contact information
Practice address
3627 UNIVERSITY BLVD S, SUITE 300, JACKSONVILLE, FL 32216-4230
(904) 396-0300
(904) 396-3039
Mailing address
3627 UNIVERSITY BLVD S, SUITE 300, JACKSONVILLE, FL 32216-4230
(904) 396-0300
(904) 396-3039
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME21067
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0418040400
—
FL
01
—
1619962230
MEDICARE NPI
FL
01
—
215889
AVMED
FL
01
—
406293079
RAILROAD MEDICARE
FL
01
—
5362087
AETNA
FL
01
—
78027
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/20/2010
Last updated
08/23/2010
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