Organization
BAPTIST ENT SPECIALISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE GRAHAM (ADMINISTRATOR)
(904) 202-5370
Entity
Organization
Contact information
Practice address
7740 POINT MEADOWS DR, SUITE 7, JACKSONVILLE, FL 32256-9179
(904) 202-6400
(904) 541-4728
Mailing address
PO BOX 41516, JACKSONVILLE, FL 32203-1516
(904) 202-5111
(904) 391-5836
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004630400
—
FL
01
—
DS0498
RR MEDICARE
FL
Enumeration date
01/31/2017
Last updated
01/31/2017
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