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 |