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NORTH OKALOOSA CLINIC CORP NPI 1508438615


NPI Information

NPI: 1508438615
Provider Name: NORTH OKALOOSA CLINIC CORP

Doing Business As: NORTH OKALOOSA CLINIC CORP

Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
550 REDSTONE AVE W STE 470
CRESTVIEW, FL
ZIP 32536
Phone: (850) 689-2229
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NORTH OKALOOSA CLINIC CORP is an obstetrics gynecology in Crestview, FL. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. NORTH OKALOOSA CLINIC CORP NPI is 1508438615. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As North Okaloosa Clinic Corp.

The provider's business location address is:

550 REDSTONE AVE W STE 470
CRESTVIEW, FL
ZIP 32536-457
Phone: (850) 689-2229
Fax: (850) 689-2580

The provider's authorized official is Jennifer L Jackson .
The authorized official title is Sr Dir Prov Enrollment & Onboarding and has the following contact phone number (615) 465-3334.

The enumeration date for this NPI number is 7/16/2021 and was last updated on 3/18/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & GynecologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1273693411MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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