| White Wilson Med Ctr-bwb Fp | |
|
2001 E Highway 20 Family Practice Department Niceville FL 32578-8826 | |
| (850) 897-4400 | |
| (850) 897-0623 |
| Full Name | White Wilson Med Ctr-bwb Fp |
|---|---|
| Speciality | Family Medicine |
| Location | 2001 E Highway 20, Niceville, Florida |
| Authorized Official Name and Position | Douglas W. Rigby (PRESIDENT) |
| Authorized Official Contact | 8508638150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| White Wilson Med Ctr-bwb Fp 1005 Mar Walt Dr Business Office Fort Walton Beach FL 32547-6707 Ph: (850) 863-8105 | White Wilson Med Ctr-bwb Fp 2001 E Highway 20 Family Practice Department Niceville FL 32578-8826 Ph: (850) 897-4400 |
| NPI Number | 1013054469 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013054469 | NPI | - | NPPES |
| 059722804 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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