Individual provider · Type 1 NPI

Mark Bazemore

Military Health Care Provider · Eglin Afb, FL

NPI number 1528909025 Active

Practice location

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302

Call (850) 883-8600 Map

Specialties and licenses

TaxonomyCodeLicense
Military Health Care Provider Primary 171000000XNone listed

Military Health Care Provider: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

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About NPI 1528909025

Mark Bazemore's National Provider Identifier is 1528909025, issued on Apr 1, 2026. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in Eglin Afb, FL. The record was last updated on May 5, 2026.