IndividualActive
Mark Bazemore
NPI 1528909025 · Military Health Care Provider · Eglin Afb, FL
Provider details
- NPI number
- 1528909025
- Entity type
- Individual
- Primary specialty
- Military Health Care ProviderOther Service Providers
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
Phone: (850) 883-8600
Approximate (ZIP-level) locationGet directions
Mailing address
307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302
Registry dates
- Enumerated
- 2026-04-01
- Last updated
- 2026-05-05
- Certified
- 2026-05-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.