Provider Demographics
NPI:1881326023
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:DC
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:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERIDIAN SPINE AND JOINT, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty