Organization
CRESTVIEW HOSPITAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SR DIR ONBOARDING & PROV ENROLLMENT)
(615) 465-3334
Entity
Organization
Contact information
Practice address
550 REDSTONE AVE W, SUITE 370, CRESTVIEW, FL 32536-6428
(850) 423-0061
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829
(615) 465-7626
(615) 465-3007
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
10/25/2007
Last updated
03/18/2022
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