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Contact Information

JERRY A BRIDGHAM, MD
14810 OLD SAINT AUGUSTINE RD STE 106
CREDENTIALING DEPARTMENT
JACKSONVILLE, FL32258-2558
 Phone: 904-268-7701
 Fax: 904-268-9708
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for JERRY A BRIDGHAM · (Male)

NPI # 1740361336
Status Active
Credentials MD
Entity Individual
Enumeration date 10/18/2006
Last updated 11/19/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME49397
  • FL Medicaid 3747107-00
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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