Jerry Alan Bridgham
MD | Pediatric Adolescent Medicine | Male
Jerry Alan Bridgham, MD is a Jacksonville, Florida based Pediatric doctor with medical specialization in
Pediatric Adolescent Medicine.
Current practice location of Jerry Alan Bridgham 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.
Jerry Alan Bridgham is a sole proprietor of his business.
NPI number (Unique professional ID) for Jerry Alan Bridgham is
1740361336 which was assigned by NPPES on 18 Oct, 2006 and it was last updated on 19 Nov, 2015.
Jerry Alan Bridgham license number is
ME49397 for Pediatrics Adolescent Medicine (2080A0000X) in Florida.
Jerry Alan Bridgham 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.
Complete Profile:
Jerry Alan Bridgham basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Jerry Alan Bridgham |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Jerry Alan Bridgham 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 : | 1740361336 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 18 Oct, 2006 |
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| Last Updated On : | 19 Nov, 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 Jerry Alan Bridgham are as mentioned. Primary taxonomy code for Jerry Alan Bridgham, MD is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080A0000X | Pediatrics Adolescent Medicine | Yes | ME49397 | FL |
Legacy Identifiers:
Other legacy medical identifiers of Jerry Alan Bridgham such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 3747107-00 | 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 44004
Jacksonville, FL, 32231-4004
United States |
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| Phone Number : | 904-202-1032 |
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| Fax Number : | 904-268-9708 |
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Business Location:
Patients can refer following map for directions to
Jerry Alan Bridgham practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.