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2190 Highway 85 N Niceville FL 32578-1045 | |
| (850) 729-9407 | |
| (850) 729-9418 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2190 Highway 85 N, Niceville, Florida |
| Authorized Official Name and Position | Mark Day (CFO) |
| Authorized Official Contact | 8507299302 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2190 Highway 85 N Niceville FL 32578-1045 Ph: (850) 729-9407 | 2190 Highway 85 N Niceville FL 32578-1045 Ph: (850) 729-9407 |
| NPI Number | 1336120187 |
|---|---|
| Provider Enumeration Date | 11/09/2005 |
| Last Update Date | 03/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336120187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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