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NPI Code Detail

MEDICARE: PREMIER MEDICAL CLINIC

MEDICARE: PREMIER MEDICAL CLINIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CB3685OTHERFLRAILROAD MCR

General Provider Information

NPI Number : 1518926799
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER MEDICAL CLINIC
Provider Business Mailing Address
First Line : 315 E ASH ST
Second Line :
City : PERRY
State : FL
Zip : 32347-2029
Country : US
Telephone Number : 850-584-3278
Fax Number : 850-584-8171
Provider Business Practice Location Address
First Line : 315 E ASH ST
Second Line :
City : PERRY
State : FL
Zip : 32347-2029
Country : US
Telephone Number : 850-584-3278
Fax Number : 850-584-8171
Authorized Official
Title or Position : OWNER
Name : KHALIL M AFSH
Credential : M.D.
Telephone Number : 850-584-3278
Provider Enumeration Date : 03/17/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

1831184910 — RANDALL HEARNE ARNP
Practice Location Address:
315 E ASH ST
PERRY, FL
32347-2029
Practice Phone: 850-584-3278
Practice Fax: 850-584-8171
1134117385 — DIANE DODGEN M.D.
Practice Location Address:
315 E ASH ST
PERRY, FL
32347-2029
Practice Phone: 850-584-3278
Practice Fax: 850-584-8171
1861440141 — TAE YU DO
Practice Location Address:
315 E ASH ST
PERRY, FL
32347-2029
Practice Phone: 850-584-3278
Practice Fax: 850-584-8171
1205885613 — ABDUL HAMID SOFI M.D.
Practice Location Address:
315 E ASH ST
PERRY, FL
32347-2029
Practice Phone: 850-584-3278
Practice Fax: 850-584-8171
1942472162 — JACKIE LYNN WALSINGHAM LMT
Practice Location Address:
315 E ASH ST
PERRY, FL
32347-2029
Practice Phone: 850-584-3278
Practice Fax: 850-584-8171
1831342880 — PREMIER MEDICAL PEDIATRICS CLINIC INC
Practice Location Address:
315 E ASH ST
PERRY, FL
32347-2029
Practice Phone: 850-838-2121
Practice Fax: 850-838-1842

Directions to “PREMIER MEDICAL CLINIC ” Practice Location

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