Provider Demographics
NPI:1265497382
Name:NAGEL, JON WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:WILLIAM
Last Name:NAGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:506 KENILWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-4426
Mailing Address - Country:US
Mailing Address - Phone:850-932-5413
Mailing Address - Fax:
Practice Address - Street 1:PEDIATRIX MEDICAL GROUP, INC.
Practice Address - Street 2:4900 BAYOU BOULEVARD #205
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503
Practice Address - Country:US
Practice Address - Phone:850-476-2387
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 258232080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine