| Northside Medical Clinic | |
|
480 Busch Dr Jacksonville FL 32218-5553 | |
| (904) 764-5000 | |
| Not Available |
| Full Name | Northside Medical Clinic |
|---|---|
| Speciality | General Practice |
| Location | 480 Busch Dr, Jacksonville, Florida |
| Authorized Official Name and Position | Sharon Minger Wilson (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 9047645000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northside Medical Clinic 480 Busch Dr Jacksonville FL 32218-5553 Ph: (904) 764-5000 | Northside Medical Clinic 480 Busch Dr Jacksonville FL 32218-5553 Ph: (904) 764-5000 |
| NPI Number | 1730378043 |
|---|---|
| Provider Enumeration Date | 10/23/2007 |
| Last Update Date | 04/01/2008 |
| Medicare PECOS PAC ID | 1951489210 |
|---|---|
| Medicare Enrollment ID | O20080428000235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730378043 | NPI | - | NPPES |
| 62840 | Other | FL | BLUE SHIELD OF FLORIDA |
| Provider Name | Donald S Freedman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982700746 PECOS PAC ID: 2163426735 Enrollment ID: I20080426000040 |
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