Organization · Type 2 NPI

Crestview Hospital Corporation

Family Medicine Physician · Crestview, FL

NPI number 1629026133 Active

Practice location

127C E. Redstone Ave
Crestview, FL 32539-5356

Call (850) 423-0061 Map

Mailing address

330 Franklin Rd # 135A-316
Brentwood, TN 37027-3280

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed
Internal Medicine Physician	207R00000X	None listed
Rural Health Clinic/Center	261QR1300X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Other family medicine physician providers in Crestview

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NPI record

NPI: 1629026133
Entity type: Organization (Type 2)
Issued: May 5, 2006
Last updated: Mar 18, 2022
Status: Active

Other names

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Gateway Medical Clinic · doing business as
Gateway Medical Clinic · doing business as

Authorized official

Jennifer L Jackson
SR Dir Onboarding & Prov Enrollment
(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 1629026133

Crestview Hospital Corporation's National Provider Identifier is 1629026133, issued on May 5, 2006. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Crestview, FL. The record was last updated on Mar 18, 2022.