Live Oak Immediate Care Center LLC

Organization Active NPI Family Medicine Physician · Jasper, FL

NPI 1407085244 · NPPES record last updated Mar 23, 2011

Key facts

NPI
1407085244
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
LIVE OAK IMMEDIATE CARE CENTER LLC
Practice address
1150 US Highway 41 NW
Jasper, FL 32052-5888
Phone
(615) 373-7600
NPI assigned
Jul 14, 2009
Organization subpart
No

Authorized official

Name
Mickey Pickler
Title
VP
Phone
(805) 523-2117

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

1150 US Highway 41 NW
Jasper, FL 32052-5888

Mailing address

1150 US Highway 41 NW
Jasper, FL 32052-5888

Other providers in Jasper, FL

All providers in Jasper, FL · Family Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.