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Organization

KEY WEST HMA PHYSICIAN MANAGEMENT LLC

Active
Other names
Key West HMA Physician Management LLC, Keys Medical Group Orthopedics
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization

Contact information

Practice address
1111 12TH ST STE 207, KEY WEST, FL 33040-3007
(305) 292-5877
(305) 292-5862
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877

Taxonomy

Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
Primary
363A00000X
Physician Assistant
363AS0400X
Surgical Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
272815013
FL
Enumeration date
06/11/2021
Last updated
03/16/2022
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