Provider Demographics
NPI:1164675070
Name:6 MEDICAL GROUP
Entity Type:Organization
Organization Name:6 MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-827-9549
Mailing Address - Street 1:8415 BAYSHORE BLVD
Mailing Address - Street 2:6 MEDICAL GROUP/SGHC
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33621-1607
Mailing Address - Country:US
Mailing Address - Phone:813-827-9549
Mailing Address - Fax:813-828-5731
Practice Address - Street 1:8415 BAYSHORE BLVD
Practice Address - Street 2:MACDILL BASE
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33621
Practice Address - Country:US
Practice Address - Phone:813-827-9549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital