| NPI | 1730378043 |
|---|---|
| Doing Business As | NORTHSIDE MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | SHARON MINGER WILSON Office Administrator 904-764-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME49644) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME 31964) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: FL OS58811) | |
| 207V00000X Obstetrics & Gynecology (Licence: FL ME31964) | |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2008-04-01 |