Organization
BAPTIST PRIMARY CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHA DONALDSON (VICE PRESIDENT)
(904) 376-3703
Entity
Organization
Contact information
Practice address
820 PRUDENTIAL DR, SUITE 304, JACKSONVILLE, FL 32207-8210
(904) 202-3860
(904) 202-3846
Mailing address
PO BOX 45443, SALT LAKE CITY, UT 84145-0443
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265495400
—
FL
01
—
45274
BCBS GROUP
FL
Enumeration date
11/10/2010
Last updated
12/12/2018
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