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NPI Code Detail

MEDICARE: CHIPOLA MEDICAL ASSOCIATES, LLC

MEDICARE: CHIPOLA MEDICAL ASSOCIATES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346778263
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHIPOLA MEDICAL ASSOCIATES, LLC
Provider Business Mailing Address
First Line : 4215 - E KELSON AVE
Second Line :
City : MARIANNA
State : FL
Zip : 32446
Country : US
Telephone Number : 850-526-3434
Fax Number : 850-526-3434
Provider Business Practice Location Address
First Line : 4215 - E KELSON AVE
Second Line :
City : MARIANNA
State : FL
Zip : 32446
Country : US
Telephone Number : 850-526-3434
Fax Number : 850-526-3434
Authorized Official
Title or Position : MANAGING MEMBER
Name : JOE H. GAY
Credential : MD
Telephone Number : 850-526-3434
Provider Enumeration Date : 05/24/2017
Last Update Date : 03/03/2026

Similar Medicare Providers

1568502805 — JULIE ANN HARRIS DNP
Practice Location Address:
4215 KELSON AVENUE , SUITE E
MARIANNA, FL
32446
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Practice Fax: 850-526-7743
1548243728 — DR. JOE HOWARD GAY MEDICAL DOCTOR
Practice Location Address:
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1790925816 — HEATHER LYNN TATUM ARNP
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MARIANNA, FL
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1912372756 — JOHN TYLER ELLERBEE ARNP
Practice Location Address:
4215 E KELSON AVE
MARIANNA, FL
32446
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1356681050 — MRS. MEGAN C MILTON ARNP
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4215 KELSON AVE STE E
MARIANNA, FL
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1295008001 — KATE FRANCES TYLER NP
Practice Location Address:
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Directions to “CHIPOLA MEDICAL ASSOCIATES, LLC ” Practice Location

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