Organization
PENSACOLA BONE & JOINT CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN THEODORE DEJONG MD (PRESIDENT)
(850) 479-7229
Entity
Organization
Contact information
Practice address
5147 N 9TH AVE, SUITE 110, PENSACOLA, FL 32504-8771
(850) 479-7229
(850) 479-7250
Mailing address
5147 N 9TH AVE, SUITE 110, PENSACOLA, FL 32504-8771
(850) 479-7229
(850) 479-7250
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
L1829
TX
207X00000X
Orthopaedic Surgery Physician
Primary
ME0053867
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009920660
—
AL
05
—
251235100
—
FL
01
—
32487
BCBS
FL
Enumeration date
08/23/2005
Last updated
08/20/2009
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