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Organization

NORTH OKALOOSA CLINIC CORP

Active
Other names
North Okaloosa Physician Group- Surgery Specialist
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTIN MUSIC (DIR PROV ENROLLMENT & ONBOARDING)
(615) 465-7377
Entity
Organization

Contact information

Practice address
550 REDSTONE AVE W STE 410, CRESTVIEW, FL 32536-6457
(850) 306-2188
(850) 398-8470
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
273693415
FL
Enumeration date
06/23/2021
Last updated
09/22/2023
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