Organization
OKALOOSA OPHTHALMOLOGY PEDIATRIC & ADULT EYE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY KRUGER MD (OWNER)
(850) 826-2903
Entity
Organization
Contact information
Practice address
1299 INDUSTRIAL DR, SUITE 200, CRESTVIEW, FL 32539-8946
(850) 683-3937
(850) 683-0227
Mailing address
1299 INDUSTRIAL DR, SUITE 200, CRESTVIEW, FL 32539-8946
(850) 683-3937
(850) 683-0227
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017548800
—
FL
01
—
MYHJK
BCBS
FL
Enumeration date
04/21/2016
Last updated
10/24/2016
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