Organization
BAY PSYCHIATRIC SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE B JERUSALEM M.D. (PRESIDENT)
(850) 271-9674
Entity
Organization
Contact information
Practice address
3227 COUNTRY CLUB DR, LYNN HAVEN, FL 32444-5125
(850) 271-9674
(850) 248-9020
Mailing address
3227 COUNTRY CLUB DR, LYNN HAVEN, FL 32444-5125
(850) 271-9674
(850) 248-9020
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
ME27468
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14310
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
07/07/2006
Last updated
08/22/2020
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