| North Okaloosa Clinic Corp | |
|
131 E Redstone Ave Ste 105 Crestview FL 32539-5355 | |
| (850) 398-8725 | |
| (850) 398-8727 |
| Full Name | North Okaloosa Clinic Corp |
|---|---|
| Speciality | General Practice |
| Location | 131 E Redstone Ave Ste 105, Crestview, Florida |
| Authorized Official Name and Position | Jennifer L Jackson (SR DIR PROV ENROLLMENT & ONBOARDING) |
| Authorized Official Contact | 6154653334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Okaloosa Clinic Corp Po Box 689022 Franklin TN 37068-9022 Ph: (615) 465-7211 | North Okaloosa Clinic Corp 131 E Redstone Ave Ste 105 Crestview FL 32539-5355 Ph: (850) 398-8725 |
| NPI Number | 1558930313 |
|---|---|
| Provider Enumeration Date | 06/24/2021 |
| Last Update Date | 05/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558930313 | NPI | - | NPPES |
| 273693408 | Medicaid | FL |
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