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Organization

NORTHWEST JACKSONVILLE PEDIATRICS, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHELLY HOLDER THOMPSON MD (DIRECTOR)
(904) 765-5249
Entity
Organization

Contact information

Practice address
3160 EDGEWOOD AVE W, JACKSONVILLE, FL 32209-2245
(904) 765-5249
(904) 765-0958
Mailing address
3160 EDGEWOOD AVE W, JACKSONVILLE, FL 32209-2245
(904) 765-5249
(904) 765-0958

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
04/15/2009
Last updated
04/15/2009
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