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General NPI Number Information
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NPI Number | 1376470914
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Entity Type | Organization
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Legal Business Name | NORTH OKALOOSA CLINIC CORP
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Dates
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Enumeration Date | 05/07/2026
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Last Update Date | 05/07/2026
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Provider Practice Location Address
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Address Line | 550 REDSTONE AVE W STE 380
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City | CRESTVIEW
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State | FL
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Zip | 32536-6428
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Country | US
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Telephone | 850-423-9976
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Fax | 850-306-3767
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Provider Business Mailing Address
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Address Line | PO BOX 689022
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City | FRANKLIN
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State | TN
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Zip | 37068-9022
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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 | DIRECTOR, PROVIDER ENROLLMENT
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Name | KRISTY MUSIC
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Credential |
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Telephone | 877-892-9815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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