Archer, Gregory Brent

Archer, Gregory Brent is an individual health care provider with primary practice located at 550-A Twin Cities Boulevard Orthopaedic And Spine Surgery Center, Niceville FL 32578. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Archer, Gregory Brent can be contacted via phone (850) 729-1444.

Contact Information

Primary practice address
550-A Twin Cities Boulevard Orthopaedic And Spine Surgery Center Niceville FL 32578
Phone: (850) 729-1444
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1039420 Florida

Profile Details

NPI number 1114085115
LBN Legal business name Archer, Gregory Brent
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2006
Last updated Jan 17th, 2011 - about 13 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 1114085115 NPPES
Florida Other EE914Z MEDICARE PTAN
Florida Other Y05UU MEDICARE PTAN

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