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Organization
KEY WEST HMA PHYSICIAN MANAGEMENT LLC
Active
Organization
KEY WEST HMA PHYSICIAN MANAGEMENT LLC
Active
Other names
Key West HMA Physician Management LLC, KEYS MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization
Contact information
Practice address
1111 12TH ST STE 104, KEY WEST, FL 33040-4084
(305) 293-1830
(305) 293-2937
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
367A00000X
Advanced Practice Midwife
—
NULL
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272815001
—
FL
Enumeration date
06/11/2021
Last updated
03/16/2022
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