Provider Demographics
NPI:1457710733
Name:KARTSONIS FAMILY MEDICINE, PLLC
Entity Type:Organization
Organization Name:KARTSONIS FAMILY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:D
Authorized Official - Last Name:KARTSONIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-322-8844
Mailing Address - Street 1:6817 SOUTHPOINT PARKWAY
Mailing Address - Street 2:SUITE 1404
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6817 SOUTHPOINT PKWY
Practice Address - Street 2:SUITE 1404
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6282
Practice Address - Country:US
Practice Address - Phone:904-322-8844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty