# DEAN EDMUND ALTENHOFEN, M.D., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003193756
- **Authorized official:** DR. DEAN E ALTENHOFEN M.D. (PHYSICIAN)
- **Authorized official phone:** (850) 475-0902

## Contact information

- **Practice address:** 6110 N DAVIS HWY, PENSACOLA, FL 32504-6950
- **Practice address phone:** (850) 475-0902
- **Practice address fax:** (850) 475-0908
- **Mailing address:** 6110 N DAVIS HWY, PENSACOLA, FL 32504-6950
- **Mailing address phone:** (850) 475-0902
- **Mailing address fax:** (850) 475-0908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME0046652 | FL | Yes |

## Other

- **Enumeration date:** 11/09/2011
- **Last updated:** 11/28/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 02245 | BLUE CROSS BLUE SHIELD OF FLORIDA | FL |
| 05 | — | 047401100 | — | FL |
| 01 | — | 59146654 | BLUE CROSS BLUE SHIELD OF ALABAMA | FL |