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General NPI Number Information
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NPI Number | 1629122148
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Entity Type | Organization
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Legal Business Name | FAMILY CARE ASSOCIATES OF NW FLORIDA
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 925 CARLISLE RD
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City | CHIPLEY
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State | FL
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Zip | 32428-4360
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Country | US
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Telephone | 850-638-9399
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Fax | 850-638-3720
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Provider Business Mailing Address
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Address Line | 925 CARLISLE RD
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City | CHIPLEY
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State | FL
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Zip | 32428-4360
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Country | US
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Telephone | 850-638-9399
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Fax | 850-638-3720
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREG KEITH SLOAN
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Credential | M.D.
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Telephone | 850-638-9399
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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 | 42501
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License Number State | FL
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