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General NPI Number Information
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NPI Number | 1265658546
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Entity Type | Organization
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Legal Business Name | GULF COAST PODIATRY OF NORTHWEST FLORIDA PA
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1851 N 9TH AVE.
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City | PENSACOLA
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State | FL
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Zip | 32503-4535
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Country | US
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Telephone | 850-434-9867
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Fax | 850-434-9878
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Provider Business Mailing Address
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Address Line | 1851 N 9TH AVE.
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City | PENSACOLA
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State | FL
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Zip | 32503-4535
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Country | US
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Telephone | 850-434-9867
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Fax | 850-434-9878
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH E KIEFER
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Credential | D.P.M.
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Telephone | 850-434-9867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO 1874
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License Number State | FL
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