Gregory Brent Archer in Niceville - Physician Assistant
Gregory Brent Archer - NPI 1114085115
Gregory Brent Archer is a Physician Assistant in Niceville, Florida. Gregory Brent Archer practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Gregory Brent Archer is 1114085115. The last update date is 2011-01-17.
Gregory Brent Archer's current location address is 550-a Twin Cities Boulevard, Niceville, Florida. You can contact this provider via phone number 8507291444. The mailing address for Gregory Brent Archer is 550-a Twin Cities Boulevard, Niceville, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gregory Brent Archer |
|---|---|
| Address | 550-a Twin Cities Boulevard, Niceville, Florida |
| Phone Number | 8507291444 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1114085115 |
|---|---|
| Provider Enumeration Date | 2006-12-04 |
| Last Updated Date | 2011-01-17 |
Provider Mailing Address Detail
| Address | 550-a Twin Cities Boulevard |
|---|---|
| City | Niceville |
| State | Florida (FL) |
| Post Code | 32578 |
| Phone Number | 8507291444 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 1039420 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| EE914Z | FL | MEDICARE PTAN | |
| Y05UU | FL | BLUECROSSBLUE SHIELD PROVIDER |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Gregory Brent Archer by the Centers for Medicare & Medicaid Services?
The Gregory Brent Archer has been assigned the NPI (National Provider Identifier) 1114085115 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete address where Gregory Brent Archer is physically located?
The Gregory Brent Archer is situated at the following address: 550-A Twin Cities Boulevard, Niceville, FL 32578.
Could you please share the complete physical location address where Gregory Brent Archer's facilities are situated?
The facilities of Gregory Brent Archer are physically located at the following address: 550-A Twin Cities Boulevard, Niceville, FL, 32578.
What is Gregory Brent Archer's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Gregory Brent Archer is Physician Assistant, and the corresponding taxonomy classification code for this specialized field is 363A00000X.
As of what date was the information pertaining to Gregory Brent Archer, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Gregory Brent Archer, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2011-01-17.