Organization
BAPTIST SPECIALTY PHYSICIANS INC
Active
Other names
Wolfson Children's Specialty Services
Organization subpart
No
Provider details
NPI number
Authorized official
THABATA FORD (VICE PRESIDENT)
(904) 202-5048
Entity
Organization
Contact information
Practice address
14540 OLD SAINT AUGUSTINE RD STE 2471, JACKSONVILLE, FL 32258-7418
(904) 202-8550
(904) 393-7808
Mailing address
PO BOX 746645, ATLANTA, GA 30374-6645
(904) 376-4083
(904) 391-5075
Taxonomy
Speciality
Code
Description
License number
State
207RA0002X
Adult Congenital Heart Disease Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
2080P0202X
Pediatric Cardiology Physician
Primary
—
—
Other
Enumeration date
08/30/2021
Last updated
04/21/2022
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