Organization
GLADNEY FAMILY MED CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHO GLADNEY (OWNER)
(470) 925-6802
Entity
Organization
Contact information
Practice address
3119 SPRING GLEN RD STE 104, JACKSONVILLE, FL 32207-5921
(470) 925-6802
Mailing address
61 MARLOW PL, ATLANTA, GA 30328-1640
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/04/2022
Last updated
02/04/2022
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