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General NPI Number Information
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NPI Number | 1295748812
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Entity Type | Organization
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Legal Business Name | NAVY
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 6000 W HIGHWAY 98 # 65
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City | PENSACOLA
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State | FL
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Zip | 32512-0001
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Country | US
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Telephone | 850-858-6732
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Fax |
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Provider Business Mailing Address
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Address Line | 6111 ENTERPRISE DR APT 804
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City | PENSACOLA
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State | FL
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Zip | 32505-1631
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | WILLIAM JAVIER DAVILA
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Credential | MD
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Telephone | 850-505-6732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number | 01058007A
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License Number State | IN
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