Crater Lake Emergency Physicians LLC

NPI #1093386443 in Live Oak, Florida

Provider Information

NPI Number: 1093386443
Entity Type: Organization
Organization Name: Crater Lake Emergency Physicians LLC
Primary Specialty: Emergency Medicine
Enumeration Date: Jul 7, 2021
Last Updated: Jul 7, 2021

Practice Location

Address: 1100 11TH ST SW
City: Live Oak
State: Florida
ZIP Code: 32064-3608
Phone: (973) 251-1132

Authorized Official

Name: CYNTHIA BUTCHER
Title: OFFICER
Phone: (973) 251-1132

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X	Primary

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