Provider Demographics
NPI:1467614651
Name:JFK INTERNAL MEDICINE FACULTY PRACTICE, LLC
Entity Type:Organization
Organization Name:JFK INTERNAL MEDICINE FACULTY PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-372-6536
Mailing Address - Street 1:2000 HEALTH PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4692
Mailing Address - Country:US
Mailing Address - Phone:615-373-7406
Mailing Address - Fax:
Practice Address - Street 1:160 JFK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6632
Practice Address - Country:US
Practice Address - Phone:561-548-6634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-28
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty