| NPI | 1942765300 |
|---|---|
| Doing Business As | THE PRACTICE |
| Entity Type | Organization |
| Authorized Contact | CHARLES B MADDIX President & Owner 904-877-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2023-07-17 |