Organization
COMMUNITY HOSPITAL FAMILY PRACTICE LLC
Active
Other names
Northpointe Physicians Group
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM TEDERICK JOHNSON (VICE PRESIDENT/AO)
(615) 372-3375
Entity
Organization
Contact information
Practice address
44 VETERANS AVE, BROOKSVILLE, FL 34601-3215
(352) 797-3500
(352) 797-3526
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4525
(615) 373-7600
(866) 346-1426
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
208600000X
Surgery Physician
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000801600
—
FL
01
—
00264
BCBS FL
FL
01
—
DO9676
MEDICARE RAILROAD GROUP
FL
Enumeration date
10/04/2007
Last updated
10/21/2020
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