Crestview Primary Care

LBN: North Okaloosa Clinic Corp
Crestview Primary Care is an health care organization with primary practice located at 524 W James Lee Blvd , Crestview FL 32536-5129. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. North Okaloosa Clinic Corp can be contacted via phone (850) 398-8725, or through Jackson, Jennifer L via phone (615) 465-3334.

Contact Information

Primary practice address
524 W James Lee Blvd Crestview FL 32536-5129
Phone: (850) 398-8725
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Jennifer L
Phone: (615) 465-3334

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1881363182
LBN Legal business name North Okaloosa Clinic Corp
DBA Doing business as Crestview Primary Care
Authorized official Jackson, Jennifer L
Entity Organization
Organization subpart 1 No
Enumeration date Sep 9th, 2021
Last updated Mar 18th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881363182 NPPES
Florida MEDICAID PENDING

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