Healthcare Provider Details

I. General information

NPI: 1245923648
Provider Name (Legal Business Name): BRETT PALMER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 BOATNER RD
EGLIN AFB FL
32542-1391
US

IV. Provider business mailing address

340 BOATNER RD
EGLIN AFB FL
32542-1391
US

V. Phone/Fax

Practice location:
  • Phone: 850-883-8600
  • Fax:
Mailing address:
  • Phone: 540-597-5078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number81713-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: