Provider Demographics
NPI:1760667620
Name:PHYSICIANS MEDICAL CENTERS-JAX INC
Entity Type:Organization
Organization Name:PHYSICIANS MEDICAL CENTERS-JAX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF URGENT CARE
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:NORVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-253-6284
Mailing Address - Street 1:2970 HARTLEY RD
Mailing Address - Street 2:SUTIE 106
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-8227
Mailing Address - Country:US
Mailing Address - Phone:904-262-9444
Mailing Address - Fax:904-262-3750
Practice Address - Street 1:1680 DUNN AVE
Practice Address - Street 2:SUITE 39
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-4782
Practice Address - Country:US
Practice Address - Phone:904-253-6286
Practice Address - Fax:904-766-7404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care