Provider Demographics
NPI:1689298689
Name:MERIDIAN SPINE AND JOINT, INC
Entity Type:Organization
Organization Name:MERIDIAN SPINE AND JOINT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NHAT
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-254-0481
Mailing Address - Street 1:9770 OLD BAYMEADOWS RD STE 139
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7986
Mailing Address - Country:US
Mailing Address - Phone:904-379-9412
Mailing Address - Fax:888-502-0725
Practice Address - Street 1:9770 OLD BAYMEADOWS RD STE 139
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7986
Practice Address - Country:US
Practice Address - Phone:904-379-9412
Practice Address - Fax:888-502-0725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty