Provider Demographics
NPI:1396305132
Name:GADSDEN COUNTY URGENT CARE
Entity type:Organization
Organization Name:GADSDEN COUNTY URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-627-1515
Mailing Address - Street 1:1608 CALLEN ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32310-6008
Mailing Address - Country:US
Mailing Address - Phone:248-763-6299
Mailing Address - Fax:
Practice Address - Street 1:23 N MADISON ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351-2409
Practice Address - Country:US
Practice Address - Phone:850-627-1515
Practice Address - Fax:850-627-1175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care