Organization
KEY WEST HMA PHYSICIAN MANAGEMENT LLC
Active
Other names
Key West HMA Physician Management LLC, Keys Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization
Contact information
Practice address
1111 12TH ST STE 109, KEY WEST, FL 33040-4087
(305) 296-1558
(305) 296-1562
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272815014
—
FL
Enumeration date
06/11/2021
Last updated
03/16/2022
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