Organization
BAPTIST ENT SPECIALISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE GRAHAM (ADMINISTRATOR)
(904) 202-5370
Entity
Organization
Contact information
Practice address
751 OAK ST, SUITE 610, JACKSONVILLE, FL 32204-3359
(904) 398-5301
(904) 398-1286
Mailing address
PO BOX 40767, JACKSONVILLE, FL 32203-0767
(904) 376-3707
(904) 391-5001
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004630400
—
FL
Enumeration date
05/14/2015
Last updated
05/14/2015
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