CAMPBELLTON-GRACEVILLE HOSPITAL NPI 1154373744

NPI Information

NPI: 1154373744
Provider Name: CAMPBELLTON-GRACEVILLE HOSPITAL
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
5429 COLLEGE DR STE B
GRACEVILLE, FL
ZIP 32440
Phone: (850) 263-4431
Get Directions

CAMPBELLTON-GRACEVILLE HOSPITAL is a family medicine in Graceville, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CAMPBELLTON-GRACEVILLE HOSPITAL NPI is 1154373744. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5429 COLLEGE DR STE B
GRACEVILLE, FL
ZIP 32440-859
Phone: (850) 263-4431
Fax: (850) 263-3312

The provider's authorized official is Judy Austin .
The authorized official title is Assistant Administrator and has the following contact phone number (850) 263-4431.

The enumeration date for this NPI number is 5/16/2006 and was last updated on 8/9/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		4172	FLORIDA	No
2	207RG0300X	Internal Medicine	Geriatric Medicine	4172	FLORIDA	No
3	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	4172	FLORIDA	No
4	363L00000X	Nurse Practitioner		4172	FLORIDA	No
5	207Q00000X	Family Medicine		4172	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	060622700	MEDICAID	FLORIDA
2	39529	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA	MCR PHY GRP PROV #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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