Provider Demographics
NPI:1285600411
Name:PINNACLE PHYSICIANS LLC
Entity type:Organization
Organization Name:PINNACLE PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:POPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-474-8000
Mailing Address - Street 1:8201 UNIVERSITY PKWY
Mailing Address - Street 2:PINNACLE PHYSICIANS LLC
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6050
Mailing Address - Country:US
Mailing Address - Phone:850-474-8688
Mailing Address - Fax:850-969-2910
Practice Address - Street 1:8201 UNIVERSITY PKWY
Practice Address - Street 2:PINNACLE PHYSICIANS LLC
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-4904
Practice Address - Country:US
Practice Address - Phone:850-474-8688
Practice Address - Fax:850-969-2910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL97928OtherBLUE SHIELD OF FL
FLK9279Medicare ID - Type Unspecified