Organization
BAPTIST PULMONARY SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHA DONALDSON (VICE PRESIDENT)
(904) 376-3707
Entity
Organization
Contact information
Practice address
1348 S 18TH ST STE 210, FERNANDINA BEACH, FL 32034-4785
(904) 261-9108
(904) 261-9911
Mailing address
PO BOX 43055, JACKSONVILLE, FL 32203-3055
(904) 261-9108
(904) 261-9911
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BY513A
GROUP MEDICARE PTAN
FL
Enumeration date
04/13/2009
Last updated
12/12/2018
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