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Organization
FOOT FIRST PODIATRY
Active
Organization
FOOT FIRST PODIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELVIN DEVANE GIPSON DPM (OWNER)
(407) 443-9784
Entity
Organization
Contact information
Practice address
2600 HOSPITAL DR, BONIFAY, FL 32425-4264
(850) 547-8117
(850) 547-8090
Mailing address
PO BOX 1199, DEFUNIAK SPRINGS, FL 32435-1199
(407) 443-9784
(850) 547-8090
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO 2195
FL
Other
Enumeration date
01/11/2013
Last updated
01/11/2013
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