Provider Demographics
NPI:1215799481
Name:PHYSICIANS ALIGNED
Entity type:Organization
Organization Name:PHYSICIANS ALIGNED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:904-349-6779
Mailing Address - Street 1:1301 MONUMENT RD STE 19
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-6462
Mailing Address - Country:US
Mailing Address - Phone:904-724-9334
Mailing Address - Fax:904-725-3120
Practice Address - Street 1:1301 MONUMENT RD STE 19
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-6462
Practice Address - Country:US
Practice Address - Phone:904-724-9334
Practice Address - Fax:904-725-3120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care