Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

North Okaloosa Clinic Corp

Organization Family Medicine Physician · NPI 1558930313

North Okaloosa Clinic Corp is a Family Medicine Physician in Crestview, Florida. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
6
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

131 E Redstone Ave Ste 105
Crestview, FL 32539-5355
Phone: (850) 398-8725
Fax: (850) 398-8727
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Family Medicine Physician Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Pediatrics Physician Taxonomy 208000000X
Pediatric Adolescent Medicine Physician Taxonomy 2080A0000X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1558930313
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Jackson — Sr Dir Prov Enrollment & Onboarding · (615) 465-3334
Other names North Okaloosa Clinic Corp; North Okaloosa Physicians Group; North Okaloosa Physicians Group
NPI enumeratedJune 24, 2021
Last updated in NPPESMay 14, 2024
Certification dateMay 14, 2024
Mailing addressPo Box 689022, Franklin, TN 37068-9022

Other providers in Crestview