# PENSACOLA BONE & JOINT CLINIC PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1104819499
- **Authorized official:** JOHN THEODORE DEJONG MD (PRESIDENT)
- **Authorized official phone:** (850) 479-7229

## Contact information

- **Practice address:** 5147 N 9TH AVE, SUITE 110, PENSACOLA, FL 32504-8771
- **Practice address phone:** (850) 479-7229
- **Practice address fax:** (850) 479-7250
- **Mailing address:** 5147 N 9TH AVE, SUITE 110, PENSACOLA, FL 32504-8771
- **Mailing address phone:** (850) 479-7229
- **Mailing address fax:** (850) 479-7250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | L1829 | TX | — |
| 207X00000X | Orthopaedic Surgery Physician | ME0053867 | FL | Yes |

## Other

- **Enumeration date:** 08/23/2005
- **Last updated:** 08/20/2009