Organization
ENT ASSOCIATES OF N.W. FLORIDA, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BUREN CLARK M.D. (PRESIDENT)
(850) 484-0520
Entity
Organization
Contact information
Practice address
4616 N DAVIS HWY, PENSACOLA, FL 32503-2337
(850) 484-8520
(850) 484-9936
Mailing address
4616 N DAVIS HWY, PENSACOLA, FL 32503-2337
(850) 484-0520
(850) 484-9936
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054720400
—
FL
Enumeration date
03/02/2006
Last updated
09/17/2012
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