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Organization

MAGNOLIA URGENT CARE, PA

Active
Other names
Magnolia Urgent Care
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM A JACOBS MD (PRESIDENT)
(904) 284-4222
Entity
Organization

Contact information

Practice address
3185 HIGHWAY 17, GREEN COVE SPRINGS, FL 32043-9371
(904) 284-4222
(904) 284-2025
Mailing address
3185 HIGHWAY 17, GREEN COVE SPRINGS, FL 32043-9371
(904) 284-4222
(904) 284-2025

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0047311
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
38927
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/06/2007
Last updated
11/06/2007
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