North Okaloosa Clinic Corp
LBN: North Okaloosa Clinic Corp
North Okaloosa Clinic Corp is an health care organization with primary practice located at 1332 N Ferdon Blvd , Crestview FL 32536-1749. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / General Practice is the primary health care specialty.
North Okaloosa Clinic Corp can be contacted via phone (850) 398-8725, or through Jackson, Jennifer L via phone (615) 465-3334.
Contact Information
Primary practice address
1332 N Ferdon Blvd
Crestview FL 32536-1749
Phone: (850) 398-8725
Fax: (850) 398-8727
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X |
Profile Details
| NPI number | 1154994697 |
|---|---|
| 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 | Jul 22nd, 2021 |
| Last updated | Mar 18th, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154994697 | NPPES |
| Florida | MEDICAID | PENDING |
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