Healthcare Provider Details

I. General information

NPI: 1831321322
Provider Name (Legal Business Name): JUSTIN DANA POISSANT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2009
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL 6000 W HWY 98
PENSACOLA FL
32512-0003
US

IV. Provider business mailing address

NAVAL HOSPITAL PENSACOLA 6000 W HWY 98 URGENT CARE CLINIC
PENSACOLA FL
32512-0003
US

V. Phone/Fax

Practice location:
  • Phone: 850-505-6199
  • Fax: 850-505-6484
Mailing address:
  • Phone: 850-505-6767
  • Fax: 850-407-4658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO2256
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS12796
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: