Organization
CAMPBELLTON-GRACEVILLE HOSPITAL
Active
Parent organization
CAMPBELLTON-GRACEVILLE HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAMPBELLTON-GRACEVILLE HOSPITAL
Authorized official
MS. JUDY AUSTIN (ASSISTANT ADMINISTRATOR)
(850) 263-4431
Entity
Organization
Contact information
Practice address
5429 COLLEGE DR STE B, GRACEVILLE, FL 32440-1859
(850) 263-4431
(850) 263-3312
Mailing address
5429 COLLEGE DR, GRACEVILLE, FL 32440-1857
(850) 263-4431
(850) 263-3312
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4172
FL
207R00000X
Internal Medicine Physician
4172
FL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
4172
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
4172
FL
363L00000X
Nurse Practitioner
4172
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060622700
—
FL
Enumeration date
05/16/2006
Last updated
08/09/2010
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