Organization Active NPI

ENT Associates of N.W. Florida, PA

  • Otolaryngology Physician
  • Pensacola, FL
National Provider Identifier
1235106733
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
ENT ASSOCIATES OF N.W. FLORIDA, PA
Practice address
4616 N Davis Hwy
Pensacola, FL 32503-2337
Phone
(850) 484-8520
Fax
(850) 484-9936
NPI assigned
Mar 2, 2006
Last updated
Sep 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. William Buren Clark, M.D.
Title
President
Phone
(850) 484-0520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

4616 N Davis Hwy
Pensacola, FL 32503-2337

Mailing address

4616 N Davis Hwy
Pensacola, FL 32503-2337
Phone (850) 484-0520

Other identifiers 1

IdentifierTypeStateIssuer
054720400MedicaidFL

National Provider Directory

National Provider Directory

Locations

4551 N Davis Hwy
Ste 2A
Pensacola, FL 32503
Phone (850) 484-0520

4616 N Davis Hwy
Pensacola, FL 32503
Phone (850) 476-8979

4616 N Davis Hwy
Ste 2A
Pensacola, FL 32503
Phone (850) 484-0520

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347840000000",
    "number": "1235106733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4616 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032337",
            "telephone_number": "850-484-0520",
            "fax_number": "850-484-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4616 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032337",
            "telephone_number": "850-484-8520",
            "fax_number": "850-484-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT ASSOCIATES OF N.W. FLORIDA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-02",
        "last_updated": "2012-09-17",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BUREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-484-0520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054720400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.