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Organization

PENSACOLA EAR NOSE AND THROAT PL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEVIN BOTTS JR. MD (PARTNER)
(850) 532-3467
Entity
Organization

Contact information

Practice address
1717 NORTH E STREET, STE 239, PENSACOLA, FL 32501
(850) 432-3467
(850) 434-2308
Mailing address
1717 NORTH E STREET, STE 239, PENSACOLA, FL 32501
(850) 432-3467
(850) 434-2308

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
276479200
FL
01
39522
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/01/2006
Last updated
09/24/2014
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