North Okaloosa Clinic Corp

LBN: North Okaloosa Clinic Corp
North Okaloosa Clinic Corp is an health care organization with primary practice located at 127 E Redstone Ave Ste B , Crestview FL 32539-5356. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as the primary health care specialty. North Okaloosa Clinic Corp can be contacted via phone (850) 689-8100, or through Jackson, Jennifer L via phone (615) 465-3334.

Contact Information

Primary practice address
127 E Redstone Ave Ste B Crestview FL 32539-5356
Phone: (850) 689-8100
Fax: (850) 689-8261
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Jennifer L
Phone: (615) 465-3334

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X

Profile Details

NPI number 1154990547
LBN Legal business name North Okaloosa Clinic Corp
DBA Doing business as North Okaloosa Clinic Corp
Authorized official Jackson, Jennifer L
Entity Organization
Organization subpart 1 No
Enumeration date Jun 21st, 2021
Last updated Mar 18th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154990547 NPPES
Florida MEDICAID 273693406

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