Organization
KEY WEST HMA PHYSICIAN MANAGEMENT LLC
Active
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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