| NPI | 1659094308 |
|---|---|
| Other Name | VILLAGE MEDICAL - SOUTHSIDE |
| Entity Type | Organization |
| Authorized Contact | KRISTI I LEE Dir Rev Cycle 904-844-2271 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2022-09-19 |