Organization
PAIN CLINIC OF NORTHWEST FL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT JAY JOSEPH M.D. (DIRECTOR)
(850) 784-2477
Entity
Organization
Contact information
Practice address
2250 HARRISON AVE, PANAMA CITY, FL 32405-4548
(850) 784-2477
(850) 784-6848
Mailing address
2250 HARRISON AVE, PANAMA CITY, FL 32405-4548
(850) 784-2477
(850) 784-6848
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PMC 150
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM7126
RRB PTAN
FL
Enumeration date
09/20/2006
Last updated
01/03/2012
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