Organization
THE WOMANS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DALE CARLSON I M.D. (PRESIDENT)
(850) 682-5332
Entity
Organization
Contact information
Practice address
492 N WILSON ST, CRESTVIEW, FL 32536-3442
(850) 682-5332
(850) 683-5333
Mailing address
492 N WILSON ST, CRESTVIEW, FL 32536-3442
(850) 682-5332
(850) 683-5333
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
ME0051484
FL
Other
Enumeration date
08/21/2008
Last updated
08/21/2008
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