Foster, Malcolm Tennyson

Foster, Malcolm Tennyson is an individual health care provider with primary practice located at 655 W 8Th St Ufjp Internal Medicine, Jacksonville FL 32209-6511. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Foster, Malcolm Tennyson can be contacted via phone (904) 244-3070.

Contact Information

Primary practice address
655 W 8Th St Ufjp Internal Medicine Jacksonville FL 32209-6511
Fax: (904) 244-3087
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME11138 Florida
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X ME11138 Florida

Profile Details

NPI number 1962478370
LBN Legal business name Foster, Malcolm Tennyson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 25th, 2006
Last updated Jun 18th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962478370 NPPES
Georgia MEDICAID 000273721A
Georgia MEDICAID 0571377-00

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