# THE PATHOLOGY GROUP OF NORTHWEST FLORIDA PLLC

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

## Provider details

- **NPI number:** 1679837116
- **Authorized official:** DR. NORTH DAVIS MD (PRESIDENT)
- **Authorized official phone:** (800) 288-8325

## Contact information

- **Practice address:** 151 E REDSTONE AVE, CRESTVIEW, FL 32539-5352
- **Practice address phone:** (850) 689-8100
- **Mailing address:** PO BOX 3093, BOCA RATON, FL 33431-0993
- **Mailing address phone:** (850) 438-1154
- **Mailing address fax:** (850) 433-6034

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/29/2012
- **Last updated:** 12/04/2022