| Heritage Family Medicine, Llc | |
|
101 E Wisconsin Ave Bonifay FL 32425-1809 | |
| (850) 547-2209 | |
| (850) 547-4521 |
| Full Name | Heritage Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 101 E Wisconsin Ave, Bonifay, Florida |
| Authorized Official Name and Position | Patrick Hawkins (PHYSICIAN) |
| Authorized Official Contact | 8505472209 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Family Medicine, Llc 101 E Wisconsin Ave Bonifay FL 32425-1809 Ph: (850) 547-2209 | Heritage Family Medicine, Llc 101 E Wisconsin Ave Bonifay FL 32425-1809 Ph: (850) 547-2209 |
| NPI Number | 1124462981 |
|---|---|
| Provider Enumeration Date | 04/24/2013 |
| Last Update Date | 04/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124462981 | NPI | - | NPPES |
| FH128Z | Other | FL | MEDICARE PTAN |
| 372395000 | Medicaid | FL | |
| 003587000 | Medicaid | FL | |
| 18651 | Other | FL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME105126 (Florida) | Primary |
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