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EGLIN AIR FORCE BASE RESIDENCY PROGRAM
NPI 1538504063
Family Medicine in St Petersburg, FL

Active since May 10, 2013
11850 DR MARTIN LUTHER KING JR ST N, APT 22-312, ST PETERSBURG, FL 33716(206) 883-5357 Get Directions Write a Review

NPPES record last updated: May 10, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Eglin Air Force Base Residency Program NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EGLIN AIR FORCE BASE RESIDENCY PROGRAM (NPI 1538504063) is a healthcare organization registered as a family medicine in St Petersburg, Florida and active in the NPI registry since May 2013. The organization lists Christopher Paulson, Program Director, as its authorized official.

NPPES Registry Identity

NPI1538504063
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameEGLIN AIR FORCE BASE RESIDENCY PROGRAM
Location Address11850 DR MARTIN LUTHER KING JR ST N, APT 22-312St Petersburg, FL 33716-1619
Mailing Address11850 Dr Martin Luther King Jr St N, Apt 22-312St Petersburg, FL 33716-1619 · (206) 883-5357
Phone(206) 883-5357
Organization SubpartNo
Authorized OfficialChristopher PaulsonProgram Director · (850) 883-8192
Enumeration DateMay 10, 2013
✔ NPI 1538504063 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/CenterTaxonomy 261Q00000X
11850 DR MARTIN LUTHER KING JR ST N, St Petersburg, FL 33716
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eglin Air Force Base Residency Program's NPI number?

The NPI number for Eglin Air Force Base Residency Program is 1538504063. It was assigned to this organization in the NPPES registry on May 10, 2013.

Where is Eglin Air Force Base Residency Program located?

Eglin Air Force Base Residency Program is located at 11850 Dr Martin Luther King Jr St N Apt 22-312, St Petersburg, FL 33716. The listed phone number is (206) 883-5357.

What is Eglin Air Force Base Residency Program's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Eglin Air Force Base Residency Program was last updated on May 10, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.