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Organization
PEA RIDGE FAMILY CARE CENTER INC
Active
Organization
PEA RIDGE FAMILY CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PURUSHOTTAM K. GARG MD (OWNER)
(850) 475-0867
Entity
Organization
Contact information
Practice address
5500 N DAVIS HWY STE 2, PENSACOLA, FL 32503-2063
(850) 475-0867
(850) 475-0895
Mailing address
5500 N DAVIS HWY STE 2, PENSACOLA, FL 32503-2063
(850) 475-0867
(850) 475-0895
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251128200
—
FL
01
—
38616
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/16/2005
Last updated
07/31/2026
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