# BRIDGEWAY CENTER INC

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

## Provider details

- **NPI number:** 1912119231
- **Authorized official:** BONNIE R BARLOW (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (850) 833-3975

## Contact information

- **Practice address:** 137 HOSPITAL DRIVE, FORT WALTON BEACH, FL 32548
- **Practice address phone:** (850) 833-7400
- **Practice address fax:** (850) 833-7434
- **Mailing address:** 137 HOSPITAL DRIVE, FORT WALTON BEACH, FL 32548
- **Mailing address phone:** (850) 833-7400
- **Mailing address fax:** (850) 833-7434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/07/2007
- **Last updated:** 11/26/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | Z134K | BCBS | — |