| Gregory Brent Archer, PA-C | |
|
550-a Twin Cities Boulevard, Orthopaedic And Spine Surgery Center, Niceville, FL 32578 | |
| (850) 729-1444 | |
| Not Available |
| Full Name | Gregory Brent Archer |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 550-a Twin Cities Boulevard, Niceville, Florida |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114085115 | NPI | - | NPPES |
| EE914Z | Other | FL | MEDICARE PTAN |
| Y05UU | Other | FL | BLUECROSSBLUE SHIELD PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 1039420 (Florida) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory Brent Archer, PA-C 550-a Twin Cities Boulevard, Orthopaedic And Spine Surgery Center, Niceville, FL 32578 Ph: (850) 729-1444 | Gregory Brent Archer, PA-C 550-a Twin Cities Boulevard, Orthopaedic And Spine Surgery Center, Niceville, FL 32578 Ph: (850) 729-1444 |
Amanda Michelle Outly, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2001 E. Highway 20, Family Medicine Department, Niceville, FL 32578 Phone: 850-897-6600 Fax: 850-897-0623 | |
Mrs. Amy M. Drab, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2600 Partin Dr N Ste 110, Niceville, FL 32578 Phone: 850-517-6578 Fax: 850-810-5488 | |
Mr. William H Diamond Jr., PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4566 E Highway 20 Ste 101, Niceville, FL 32578 Phone: 850-897-7546 | |
Leah Tedder, Physician Assistant Medicare: Medicare Enrolled Practice Location: 2190 Highway 85 N, Niceville, FL 32578 Phone: 850-729-9490 | |
Harry F Johnson, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 550 Twin Cities Blvd, Suite A, Niceville, FL 32578 Phone: 850-729-1444 Fax: 850-729-0300 | |
Rustin G Sorensen, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1950 Bluewater Blvd, Suite 100, Niceville, FL 32578 Phone: 850-897-8081 Fax: 850-897-3846 |