Organization
WAKULLA URGENT CARE & DIAGNOSTIC CENTER PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID A KEEN MD (MANAGER)
(850) 926-3140
Entity
Organization
Contact information
Practice address
41 FELI WAY, CRAWFORDVILLE, FL 32327-2368
(850) 926-3140
(850) 926-3163
Mailing address
41 FELI WAY, CRAWFORDVILLE, FL 32327-2368
(850) 926-3140
(850) 926-3163
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
CCN 10-3815
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002074400
—
FL
05
—
002074401
—
FL
05
—
275271900
—
FL
Enumeration date
11/08/2007
Last updated
02/20/2014
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