Clark Family Medicine
Clinic/Center, Primary Care in Miramar Beach, FL. Organization (NPI-2).
NPI number1194199919
StatusActive
Last updated in NPPESNov 17, 2015
Details
- NPI
- 1194199919
- Entity type
- Organization (NPI-2)
- Legal business name
- Clark Family Medicine
- Organization subpart
- No
- Enumeration date
- Nov 17, 2015
- Last updated
- Nov 17, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | me0073997 | FL | Yes |
Practice location
12815 Us Highway 98 W Ste 116Miramar Beach, FL 32550-3245
Phone 850-269-0111 · Fax 850-269-0114
Mailing address
12815 Us Highway 98 W Ste 116Miramar Beach, FL 32550-3245
Phone 850-269-0111 · Fax 850-269-0114
Authorized official
Lisa Bardy Clark
Owner
8502690111
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Primary Care Clinic/Center providers in Miramar Beach, FL
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.