John R. Brent Md Pa in Fort Walton Beach - Specialist
John R. Brent Md Pa - NPI 1679762611
John R. Brent Md Pa is a Specialist in Fort Walton Beach, Florida. John R. Brent Md Pa practices all healthcare services and medical treatments related to Specialist. The NPI Number for John R. Brent Md Pa is 1679762611. The last update date is 2013-01-15.
John R. Brent Md Pa's current location address is 1032 Mar Walt Dr, Fort Walton Beach, Florida. You can contact this provider via phone number 8507963737 and fax number 8507963739. The mailing address for John R. Brent Md Pa is 1032 Mar Walt Dr, Fort Walton Beach, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | John R. Brent Md Pa |
|---|---|
| Address | 1032 Mar Walt Dr, Fort Walton Beach, Florida |
| Phone Number | 8507963737 |
| Fax Number | 8507963739 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Brent R John |
| Credentials | M.D., P.A. |
| Telephone Number | 8507963737 |
NPI Number Detail
| NPI Number | 1679762611 |
|---|---|
| Provider Enumeration Date | 2007-10-16 |
| Last Updated Date | 2013-01-15 |
Provider Mailing Address Detail
| Address | 1032 Mar Walt Dr |
|---|---|
| City | Fort Walton Beach |
| State | Florida (FL) |
| Post Code | 325476661 |
| Phone Number | 8507963737 |
| Fax Number | 8507963739 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | ME92355 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| ME92355 | MEDICAL LICENSE |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to John R. Brent Md Pa by the Centers for Medicare & Medicaid Services?
The John R. Brent Md Pa has been assigned the NPI (National Provider Identifier) 1679762611 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you share the physical location details of John R. Brent Md Pa?
The John R. Brent Md Pa is situated at 1032 Mar Walt Dr, in the city of Fort Walton Beach, state of FL, with the zip code 325476661.
What is John R. Brent Md Pa's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for John R. Brent Md Pa is Specialist, and the corresponding taxonomy classification code for this specialized field is 174400000X.
On what date did the John R. Brent Md Pa receive the assignment of its 1679762611 from the Centers for Medicare & Medicaid Services?
The John R. Brent Md Pa was issued its 1679762611 by the Centers for Medicare & Medicaid Services on 2007-10-16.
As of what date were the details related to John R. Brent Md Pa most recently updated or revised?
The information pertaining to John R. Brent Md Pa, including its address, specialty, and other relevant details, was last updated or revised on 2013-01-15.
NPI Number: 1457354839
Address: P.o. Box 1252, Spartanburg, SC