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Organization
NORTH OKALOOSA CLINIC CORP
Active
Organization
NORTH OKALOOSA CLINIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRISTINA MUSIC (DIRECTOR,PROVIDER ENROLLMENT)
(877) 892-9815
Entity
Organization
Contact information
Practice address
550 REDSTONE AVE W, STE. 370, CRESTVIEW, FL 32536-6428
(850) 682-2209
(850) 682-2528
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 628-6038
(615) 628-6832
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
FL
208000000X
Pediatrics Physician
—
—
208800000X
Urology Physician
—
—
208M00000X
Hospitalist Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273693400
—
FL
01
—
33565
BCBS
FL
Enumeration date
05/04/2006
Last updated
09/23/2024
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