| Spanish Trail Family Physicians, Pa | |
|
3298 Summit Blvd Ste 16 Pensacola FL 32503 | |
| (850) 433-5544 | |
| Not Available |
| Full Name | Spanish Trail Family Physicians, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 3298 Summit Blvd, Pensacola, Florida |
| Authorized Official Name and Position | Don Buckley (PRESIDENT) |
| Authorized Official Contact | 8504335544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spanish Trail Family Physicians, Pa 3298 Summit Blvd Ste 16 Pensacola FL 32503 Ph: (850) 433-5544 | Spanish Trail Family Physicians, Pa 3298 Summit Blvd Ste 16 Pensacola FL 32503 Ph: (850) 433-5544 |
| NPI Number | 1912011669 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3173711983 |
|---|---|
| Medicare Enrollment ID | O20101221000547 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912011669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Nicholas J Delgado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316053358 PECOS PAC ID: 6103014923 Enrollment ID: I20101230000169 |
| Provider Name | Don W Buckley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114031085 PECOS PAC ID: 1658569470 Enrollment ID: I20101230000217 |
| Provider Name | Janice M Buckley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487768107 PECOS PAC ID: 3476741299 Enrollment ID: I20101230000262 |
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