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Organization
PENSACOLA PRIMARY CARE INC
Active
Organization
PENSACOLA PRIMARY CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICKEY PICKLER (VP)
(850) 523-2117
Entity
Organization
Contact information
Practice address
2120 EAST JOHNSON AVENUE, SUITE 103, PENSACOLA, FL 32514-6050
(850) 494-3965
(850) 494-3966
Mailing address
3 MARYLAND FARMS, SUITE 250, BRENTWOOD, TN 37027-5005
(800) 661-3365
(866) 689-4661
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261180500
—
FL
Enumeration date
06/05/2006
Last updated
10/15/2008
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