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NPI Profile for NORTH OKALOOSA CLINIC CORP in CRESTVIEW, FL.
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] | |
Adolescent Medicine |
2080A0000X | 37 | Physician/Pediatric Medicine | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice | |
Internal Medicine |
207R00000X | 11 | Physician/Internal Medicine | |
Pediatrics |
208000000X | 37 | Physician/Pediatric Medicine | |
Physician Assistant |
363A00000X | 97 | Physician Assistant |
| NPI # | 1558930313 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 06/24/2021 | |
| Last updated | 05/14/2024 - About 2 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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NORTH OKALOOSA CLINIC CORP
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NORTH OKALOOSA CLINIC CORP