| Gateway Medical Clinic Defuniak | |
|
650 Us Highway 331 S Ste. 4 Defuniak Springs FL 32435-3349 | |
| (850) 892-3366 | |
| Not Available |
| Full Name | Gateway Medical Clinic Defuniak |
|---|---|
| Speciality | Family Medicine |
| Location | 650 Us Highway 331 S, Defuniak Springs, Florida |
| Authorized Official Name and Position | Jennifer L Jackson (SR DIR ONBOARDING & PROV ENROLLMENT) |
| Authorized Official Contact | 6154653334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Medical Clinic Defuniak 7100 Commerce Way Ste. 180 Brentwood TN 37027-2829 Ph: (615) 465-7626 | Gateway Medical Clinic Defuniak 650 Us Highway 331 S Ste. 4 Defuniak Springs FL 32435-3349 Ph: (850) 892-3366 |
| NPI Number | 1902854425 |
|---|---|
| Provider Enumeration Date | 05/05/2006 |
| Last Update Date | 03/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902854425 | NPI | - | NPPES |
| 660058101 | Medicaid | FL | |
| 40043A | Other | FL | BCBS OF FL |
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