| NPI | 1144899014 |
|---|---|
| Doing Business As | NORTH OKALOOSA PHYSICIAN GROUP PULMONO |
| Doing Business As | NORTH OKALOOSA CLINIC CORP |
| Entity Type | Organization |
| Authorized Contact | JENNIFER L JACKSON Sr Dir Prov Enrollment & Onboarding 615-465-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical | |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2022-03-18 |