Organization Name: | OKALOOSA CARDIOLOGY P A |
NPI Number: | 1144270240 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DONNA M GIBSON (BILLING MANAGER) |
Mailing Address: | 129 E Redstone Ave Suite A Crestview |
State: | FL US |
Postal Code: | 325395350 |
Phone Number: | 8506827212 |
Fax Number: | |
NPI Enumeration Date: | 05/11/2006 |
NPI Last Update Date: | 08/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0129X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Vascular Surgery |
Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |