Gary Glen Soud
MD | Pediatrics | Male
Gary Glen Soud, MD is a Jacksonville, Florida based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Gary Glen Soud is
14810 Old Saint Augustine Rd Ste 106, Credentialing Department, Jacksonville, Florida - 32258-2558. He can be contacted on phone at
904-268-7701 and fax number 904-268-9708.
Gary Glen Soud is a sole proprietor of his business.
NPI number (Unique professional ID) for Gary Glen Soud is
1992746283 which was assigned by NPPES on 09 Jun, 2006 and it was last updated on 03 Feb, 2015.
Gary Glen Soud license number is
ME29971 for Pediatrics (208000000X) in Florida.
Gary Glen Soud is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Gary Glen Soud basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Gary Glen Soud |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Gary Glen Soud address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 14810 Old Saint Augustine Rd Ste 106, Credentialing Department
Jacksonville, FL, 32258-2558
United States |
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| Phone Number : | 904-268-7701 |
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| Fax Number : | 904-268-9708 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1992746283 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 09 Jun, 2006 |
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| Last Updated On : | 03 Feb, 2015 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Gary Glen Soud are as mentioned. Primary taxonomy code for Gary Glen Soud, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | ME29971 | FL |
Legacy Identifiers:
Other legacy medical identifiers of Gary Glen Soud such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 059637701 | MEDICAID | FL | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 40767, Credentialing Department
Jacksonville, FL, 32203-0767
United States |
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| Phone Number : | 904-376-3707 |
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| Fax Number : | 904-391-5807 |
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Business Location:
Patients can refer following map for directions to
Gary Glen Soud practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.