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General NPI Number Information
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NPI Number | 1659442457
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Entity Type | Organization
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Legal Business Name | GRANT CENTER HOSPITAL OF OCALA INC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 2382 CRAWFORDVILLE HWY SUITE C
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City | CRAWFORDVILLE
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State | FL
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Zip | 32327-1034
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Country | US
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Telephone | 850-926-6363
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Fax | 850-926-2602
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Provider Business Mailing Address
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Address Line | 1 MARYLAND FARMS SUITE 200
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City | BRENTWOOD
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State | TN
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Zip | 37027-5006
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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 | VICE PRESIDENT
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Name | MICKEY PICKLER
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Credential |
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Telephone | 850-926-6363
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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 |
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License Number State | FL
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