Jerry Alan Bridgham in Jacksonville - Adolescent Medicine
Jerry Alan Bridgham - NPI 1740361336
Jerry Alan Bridgham is a Adolescent Medicine in Jacksonville, Florida. Jerry Alan Bridgham practices all healthcare services and medical treatments related to Adolescent Medicine. The NPI Number for Jerry Alan Bridgham is 1740361336. The last update date is 2015-11-19.
Jerry Alan Bridgham's current location address is 14810 Old Saint Augustine Rd Ste 106, Jacksonville, Florida. You can contact this provider via phone number 9042687701 and fax number 9042689708. The mailing address for Jerry Alan Bridgham is 14810 Old Saint Augustine Rd Ste 106, Jacksonville, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jerry Alan Bridgham |
|---|---|
| Address | 14810 Old Saint Augustine Rd Ste 106, Jacksonville, Florida |
| Phone Number | 9042687701 |
| Fax Number | 9042689708 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1740361336 |
|---|---|
| Provider Enumeration Date | 2006-10-18 |
| Last Updated Date | 2015-11-19 |
Provider Mailing Address Detail
| Address | 14810 Old Saint Augustine Rd Ste 106 |
|---|---|
| City | Jacksonville |
| State | Florida (FL) |
| Post Code | 322582558 |
| Phone Number | 9042687701 |
| Fax Number | 9042689708 |
Provider's Primary Taxonomy Detail
| Speciality | Adolescent Medicine |
|---|---|
| Taxonomy | 2080A0000X |
| Licence No | ME49397 |
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Definition: A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3747107-00 | FL | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Jerry Alan Bridgham by the Centers for Medicare & Medicaid Services?
The Jerry Alan Bridgham has been issued the NPI (National Provider Identifier) 1740361336. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Jerry Alan Bridgham is geographically located?
The Jerry Alan Bridgham is physically situated at the following location: 14810 Old Saint Augustine Rd Ste 106, Jacksonville, FL, 322582558.
What is Jerry Alan Bridgham's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Jerry Alan Bridgham is Adolescent Medicine, and the taxonomy code that classifies this field of practice is 2080A0000X.
On what date did the Jerry Alan Bridgham receive its 1740361336 assignment from the Centers for Medicare & Medicaid Services?
The Jerry Alan Bridgham was assigned its 1740361336 by the Centers for Medicare & Medicaid Services on 2006-10-18.
As of what date were the details related to Jerry Alan Bridgham most recently updated or revised?
The information pertaining to Jerry Alan Bridgham, including its address, specialty, and other relevant details, was last updated or revised on 2015-11-19.
NPI Number: 1720081763
Address: 675 E Highway 60, Hardinsburg, KY