Organization
CHARLES P. ADAMS JR. MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES P ADAMS JR. M.D (PHYSICIAN)
(904) 354-2114
Entity
Organization
Contact information
Practice address
1034 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4123
(904) 354-2114
(904) 354-2122
Mailing address
1034 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4123
(904) 354-2114
(904) 354-2122
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0045165
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15929
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/22/2006
Last updated
12/03/2007
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