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General NPI Number Information
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NPI Number | 1013377795
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Entity Type | Organization
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Legal Business Name | NATURE COAST HIGH RISK MEDICAL MANAGEMENT LLC
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 06/16/2020
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Provider Practice Location Address
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Address Line | 7562 W GULF TO LAKE HWY
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-7840
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Country | US
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Telephone | 352-436-4328
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Fax | 352-260-0960
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Provider Business Mailing Address
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Address Line | 7562 W GULF TO LAKE HWY
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-7840
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Country | US
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Telephone | 352-436-4328
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Fax | 352-260-0960
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Authorized Official
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Title or Position | OWNER
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Name | KENNETH L SAVAGE JR.
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Credential | DO
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Telephone | 352-436-4328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS10486
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License Number State | FL
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