Provider Demographics
NPI:1891094264
Name:BAPTIST ENT SPECIALISTS INC
Entity Type:Organization
Organization Name:BAPTIST ENT SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MENGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-376-4275
Mailing Address - Street 1:4130 SALISBURY RD
Mailing Address - Street 2:SUITE 1900
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-8031
Mailing Address - Country:US
Mailing Address - Phone:904-281-0234
Mailing Address - Fax:904-281-0236
Practice Address - Street 1:4130 SALISBURY RD
Practice Address - Street 2:SUITE 1900
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8031
Practice Address - Country:US
Practice Address - Phone:904-281-0234
Practice Address - Fax:904-281-0236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty