Organization
CONCENTRA MEDICAL CENTER-JAX NORTHSIDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM FOGARTY MD (EVP, CMO)
(800) 232-3550
Entity
Organization
Contact information
Practice address
1215 DUNN AVE, STE. 7, JACKSONVILLE, FL 32218-6330
(904) 757-5656
(904) 757-5650
Mailing address
5080 SPECTRUM DR, STE. 1200 WEST TOWER, ADDISON, TX 75001-4648
(800) 232-3550
(800) 401-6728
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
09/18/2007
Last updated
09/18/2007
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