Organization · Type 2 NPI

North Okaloosa Clinic Corp

General Practice Physician · Crestview, FL

NPI number 1154994697 Active

Practice location

1332 N Ferdon Blvd
Crestview, FL 32536-1749

Call (850) 398-8725 Map

Fax (850) 398-8727

Mailing address

PO Box 689022
Franklin, TN 37068-9022

Specialties and licenses

Taxonomy	Code	License
General Practice Physician Primary	208D00000X	None listed
Physician Assistant	363A00000X	None listed
Nurse Practitioner	363L00000X	None listed

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

3 other providers at this address

Other general practice physician providers in Crestview

See all in Crestview →

NPI record

NPI: 1154994697
Entity type: Organization (Type 2)
Issued: Jul 22, 2021
Last updated: Mar 18, 2022
Status: Active

Other names

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Nopg Walk- In Clinic · doing business as
North Okaloosa Clinic Corp · doing business as
North Okaloosa Clinic Corp · doing business as

Authorized official

Jennifer L Jackson
SR Dir Prov Enrollment & Onboarding
(615) 465-3334

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1154994697

North Okaloosa Clinic Corp's National Provider Identifier is 1154994697, issued on Jul 22, 2021. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Crestview, FL. The record was last updated on Mar 18, 2022.