Genesis Obgyn Pa

NPI 1407083884 - Obstetrics & Gynecology - 207V00000X

NPI Details
NPI 1407083884
Enumeration Date 06/12/2009
Last Updated 09/13/2011
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name JENNIFER W JENNIFER
Position OWNER
Phone (850) 362-6435
Fax (850) 362-6777
Practice Location
1025 BEAL PKWY NW
FORT WALTON BEACH FL, 32547-1446, US
Phone (850) 362-6435
Fax (850) 362-6777
Business Location
1025 BEAL PKWY NW
FORT WALTON BEACH FL, 32547-1446, US
Phone (850) 362-6435
Fax (850) 362-6777
Toxanomy
Taxonomy Code 207V00000X
License State Florida
License Number ME98995
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According to our database, Genesis Obgyn Pa NPI is 1407083884, taxonomy code is 207V00000X and license number is ME98995, license state is located at Florida. Genesis Obgyn Pa physically located at 1025 Beal Pkwy Nw, Fort Walton Beach FL, 32547-1446. NPI Number 1033115704 has the healthcare provider type.

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1407083884 NPI number is provided on an as is basis without warranty of any kind. 1407083884 is maintained by the National Plan & Provider Enumeration System. The contents of Genesis Obgyn Pa are for informational purposes only.