Southern Medical Clinic PA

NPI #1437214541 in Macclenny, Florida

Provider Information

NPI Number: 1437214541
Entity Type: Organization
Organization Name: Southern Medical Clinic PA
Primary Specialty: Family Medicine
Enumeration Date: Dec 27, 2006
Last Updated: Mar 13, 2012

Practice Location

Address: 32 S 5TH ST
City: Macclenny
State: Florida
ZIP Code: 32063-2302
Phone: (904) 259-9377

Authorized Official

Name: MRS. KATHLEEN BRIDGEMAN
Title: PRESIDENT
Phone: (904) 259-9377

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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