Organization
NORTH FLORIDA OBSTETRIC & GYN CENTER PA
Active
Other names
DR BRYCE V JACKSON
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYCE VINCENT JACKSON M.D. (PRESIDENT)
(850) 784-6877
Entity
Organization
Contact information
Practice address
1937 HARRISON AVE, PANAMA CITY, FL 32405-4543
(850) 784-6877
(850) 785-5346
Mailing address
1937 HARRISON AVE, PANAMA CITY, FL 32405-4543
(850) 784-6877
(850) 785-5346
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME48532
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03638
BLUE CROSS BLUE SHIELD
FL
05
—
043532500
—
FL
Enumeration date
01/05/2007
Last updated
01/15/2014
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