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General NPI Number Information
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NPI Number | 1760505457
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Entity Type | Individual
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Provider Name | LINDA FORD PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 9400 UNIVERSITY PKWY SUITE 200
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City | PENSACOLA
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State | FL
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Zip | 32514-5752
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Country | US
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Telephone | 850-208-6285
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Fax |
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Provider Business Mailing Address
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Address Line | 3712 LONE FOX CT
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City | PACE
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State | FL
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Zip | 32571-9665
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Country | US
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Telephone | 561-633-9913
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9101814
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License Number State | FL
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