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NPI Code Detail

MEDICARE: NORTH FLORIDA OBSTETRIC & GYN CENTER PA

MEDICARE: NORTH FLORIDA OBSTETRIC & GYN CENTER PA
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
1174400000XSpecialistME48532FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
103638OTHERFLBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790832210
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH FLORIDA OBSTETRIC & GYN CENTER PA
Provider Business Mailing Address
First Line : 1937 HARRISON AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4543
Country : US
Telephone Number : 850-784-6877
Fax Number : 850-785-5346
Provider Business Practice Location Address
First Line : 1937 HARRISON AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4543
Country : US
Telephone Number : 850-784-6877
Fax Number : 850-785-5346
Authorized Official
Title or Position : PRESIDENT
Name : DR. BRYCE VINCENT JACKSON
Credential : M.D.
Telephone Number : 850-784-6877
Provider Enumeration Date : 01/05/2007
Last Update Date : 01/15/2014

Similar Medicare Providers

1467423632 — MR. BRYCE V JACKSON M.D.
Practice Location Address:
1937 HARRISON AVE
PANAMA CITY, FL
32405-4543
Practice Phone: 850-784-6877
Practice Fax: 850-785-5346
1205896636 — DR. KEITH B BANTON M.D.
Practice Location Address:
1937 HARRISON AVE
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32405-4543
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1437114634 — ZAKIRHUSAIN I PATEL MD
Practice Location Address:
1937 HARRISON AVE
PANAMA CITY, FL
32405-4543
Practice Phone: 850-769-2393
Practice Fax: 850-215-2456
1235150863 — PANAMA CITY PEDIATRICS PA
Practice Location Address:
1937 HARRISON AVE
PANAMA CITY, FL
32405-4543
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Practice Fax: 850-747-0194
1790877512 — HEATHER SHAFFER MD PA
Practice Location Address:
1937 HARRISON AVE
PANAMA CITY, FL
32405-4543
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1457556995 — ZAKIR PATEL MD PA
Practice Location Address:
1937 HARRISON AVE
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32405-4543
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Directions to “NORTH FLORIDA OBSTETRIC & GYN CENTER PA ” Practice Location

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