Organization
BAPTIST PRIMARY CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHA DONALDSON (VICE-PRESIDENT)
(904) 376-3703
Entity
Organization
Contact information
Practice address
1029 ATLANTIC BLVD, ATLANTIC BEACH, FL 32233
(904) 246-7520
(904) 246-7527
Mailing address
PO BOX 45443, SALT LAKE CITY, UT 84145-0443
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH3780
RR MEDICARE
FL
Enumeration date
02/16/2017
Last updated
11/11/2021
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