Individual Provider
Individual Provider is a Military Hospital in Eglin, Florida. Registered with an NPI since 2012.
- In the registry since
- 2012
Practice location Address checks out
307 Boatner Rd Ste 114 96TH Medical GroupEglin, FL 32542
Phone: (850) 883-8600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Military Hospital (primary) | Taxonomy 286500000X |
|---|
Record details
| NPI number | 1376890293 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Chuong Thai — Major · (850) 883-9055 |
| NPI enumerated | August 9, 2012 |
| Last updated in NPPES | September 14, 2012 |
| Mailing address | 307 Boatner Road Suite 114, 96th Medical Group, Eglin, FL 32542 |