Organization
FABEN OBG INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA A HAMPTON (ADMINISTRATOR)
(904) 346-0050
Entity
Organization
Contact information
Practice address
836 PRUDENTIAL DR, SUITE 1506, JACKSONVILLE, FL 32207-8334
(904) 346-0050
(904) 346-0080
Mailing address
836 PRUDENTIAL DR, SUITE 1506, JACKSONVILLE, FL 32207-8334
(904) 346-0050
(904) 346-0080
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/16/2006
Last updated
08/22/2020
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