| NPI | 1912545955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA PATTON Practice Manager 850-420-5420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2022-02-04 |