NPI 1609189901 · live from the CMS NPI Registry
Terrell Bacchus, MD
Family Medicine in Jacksonville, FL. National Provider Identifier 1609189901, active.
NPI record
| NPI | 1609189901 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 9422 Arlington Expy, Jacksonville, FL 32225 |
| Practice phone | 904-559-1844 |
| Mailing address | 2124 Candler Rd, Decatur, GA 30032 |
| Enumerated | July 15, 2010 |
| Last updated | November 21, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine | 207Q00000X | 70039 (GA) |
| Family Medicine | 207Q00000X | 24746 (NH) |
| Family Medicine primary | 207Q00000X | ME136868 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.