Organization
ER PHYSICIANS GROUP AT JACKSON HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA SUE MONIZ (DIRECTOR OF PHYSICIAN PRACTICES)
(850) 718-2677
Entity
Organization
Contact information
Practice address
436 3RD AVE, SUITE A, MARIANNA, FL 32446
(850) 718-2677
Mailing address
4250 HOSPITAL DR, MARIANNA, FL 32446-1917
(850) 718-2677
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5101019459
MI
Other
Enumeration date
04/28/2014
Last updated
04/28/2014
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