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Organization
NICEVILLE PRIMARY CARE BLUEWATER
Active
Organization
NICEVILLE PRIMARY CARE BLUEWATER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICKEY PICKLER (VP)
(850) 523-2117
Entity
Organization
Contact information
Practice address
4400 E HIGHWAY 20, SUITE 203, NICEVILLE, FL 32578-8779
(850) 897-3678
(850) 897-3708
Mailing address
4400 E HIGHWAY 20, SUITE 203, NICEVILLE, FL 32578-8779
(850) 897-3678
(850) 897-3708
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/04/2006
Last updated
09/28/2007
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