Provider Demographics
NPI:1366566077
Name:HEMATOLOGY ONCOLOGY ASSOCIATES OF NORTHWEST FLORIDA LLP
Entity type:Organization
Organization Name:HEMATOLOGY ONCOLOGY ASSOCIATES OF NORTHWEST FLORIDA LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:R.
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MABRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-877-8166
Mailing Address - Street 1:1632 RIGGINS RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5316
Mailing Address - Country:US
Mailing Address - Phone:850-877-8166
Mailing Address - Fax:
Practice Address - Street 1:1632 RIGGINS RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5316
Practice Address - Country:US
Practice Address - Phone:850-877-8166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty