Organization
BAPTIST SPECIALTY PHYSICIANS INC
Active
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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