Cross Creek Medical Pa
Internal Medicine Physician in Tallahassee, FL(View on Map)
Legal Business Name
Cross Creek Medical Pa
NPI Number
1447438486
NPI Type
Organization
Enumeration Date
02/01/2008
Specialties
(Taxonomies)Licenses
State
Florida
License Number
0071014FLME
Contact
Information
Purpose
Mailing
Location
Address
1381A CROSS CREEK CIR
1381 CROSS CREEK CIR
City
Tallahassee
Tallahassee
State
FL
FL
Postal Code
32301-3729
32301-3723
Country
US
US
Telephone Number
(850) 877-6393
(850) 877-6393
Authorized Official
Name
Dr. Wayne Sampson
Title or Position
MEDICAL DIRECTOR
Telephone Number
(850) 877-6393
Identifiers
Identifier
250984900
DF9814
003457000
Identifier State
FL
FL
FL
Identifier Issuer
Unknown
RAILROAD MEDICARE
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 10/05/2011
Provider Address
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