Provider Demographics
NPI:1023168671
Name:COASTAL OB GYN PA
Entity type:Organization
Organization Name:COASTAL OB GYN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:K
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-785-0515
Mailing Address - Street 1:600 N COVE BLVD
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-3628
Mailing Address - Country:US
Mailing Address - Phone:850-785-0515
Mailing Address - Fax:850-785-1995
Practice Address - Street 1:600 N COVE BLVD
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3628
Practice Address - Country:US
Practice Address - Phone:850-785-0515
Practice Address - Fax:850-785-1995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS3867207V00000X
FLARNP2982552363LW0102X
FLARNP827662367A00000X
FLME65397207V00000X
FLME75682207V00000X
FLME64912207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33087OtherBCBS
FL33087OtherBCBS