| Eglin Air Force Base Residency Program | |
|
11850 Dr Martin Luther King Jr St N Apt 22-312 St Petersburg FL 33716-1619 | |
| (206) 883-5357 | |
| Not Available |
| Full Name | Eglin Air Force Base Residency Program |
|---|---|
| Speciality | Family Medicine |
| Location | 11850 Dr Martin Luther King Jr St N, St Petersburg, Florida |
| Authorized Official Name and Position | Christopher Paulson (PROGRAM DIRECTOR) |
| Authorized Official Contact | 8508838192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eglin Air Force Base Residency Program 11850 Dr Martin Luther King Jr St N Apt 22-312 St Petersburg FL 33716-1619 Ph: (206) 883-5357 | Eglin Air Force Base Residency Program 11850 Dr Martin Luther King Jr St N Apt 22-312 St Petersburg FL 33716-1619 Ph: (206) 883-5357 |
| NPI Number | 1538504063 |
|---|---|
| Provider Enumeration Date | 05/10/2013 |
| Last Update Date | 05/10/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538504063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Florida) | Primary |
| 261Q00000X | Clinic/center | (Florida) | Secondary |
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