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Organization

RIVERSIDE SPINE & PAIN PHYSICIANS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JENNIFER B BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5900
Entity
Organization

Contact information

Practice address
7207 GOLDEN WINGS RD STE 100, JACKSONVILLE, FL 32244-3324
(904) 389-1010
(904) 389-1082
Mailing address
7207 GOLDEN WINGS RD STE 100, JACKSONVILLE, FL 32244-3324
(904) 389-1010
(904) 389-1082

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME83572
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2947648
AETNA
FL
01
34167
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/05/2007
Last updated
07/14/2022
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