Organization
MOTHER FRANCES HOSPITAL JACKSONVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENZIE TARR (CREDENTIALING SPECIALIST)
(903) 531-5185
Entity
Organization
Contact information
Practice address
2026 S JACKSON ST, JACKSONVILLE, TX 75766-5822
(903) 531-4500
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165773601
—
TX
Enumeration date
03/15/2007
Last updated
06/23/2008
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