Individual
GARY L BELANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1717 N E ST, SUITE 231, PENSACOLA, FL 32501-6339
(850) 469-7975
(850) 469-2113
Mailing address
PO BOX 17567, PENSACOLA, FL 32522-7567
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA279
AL
363A00000X
Physician Assistant
Primary
PA9106277
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051512155
BLUE CROSS BLUE SHIELD AL
AL
01
—
510-50070
BCBS OF ALABAMA
AL
05
—
528701110
—
AL
01
—
CA0084
RR MEDICARE
AL
Enumeration date
06/14/2006
Last updated
11/18/2011
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