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General NPI Number Information
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NPI Number | 1063812675
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Entity Type | Organization
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Legal Business Name | NILSSEN ORTHOPEDICS PA
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Dates
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Enumeration Date | 09/02/2014
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Last Update Date | 09/02/2014
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Provider Practice Location Address
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Address Line | 9400 UNIVERSITY PKWY SUITE 406
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City | PENSACOLA
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State | FL
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Zip | 32514-5752
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Country | US
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Telephone | 850-916-8711
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Fax | 850-916-8629
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Provider Business Mailing Address
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Address Line | 1040 GULF BREEZE PKWY SUITE 200
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City | GULF BREEZE
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State | FL
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Zip | 32561-7809
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Country | US
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Telephone | 850-916-8711
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Fax | 850-916-8629
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Authorized Official
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Title or Position | OWNER
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Name | ERIK C. NILSSEN
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Credential | MD
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Telephone | 850-916-8711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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