is a Surgery in Panama City, Florida. practices all healthcare services and medical treatments related to Surgery. The NPI Number for is 1710037692. The last update date is .
's current location address is 801 E 6th St. Ste. 602, Panama City, Florida. You can contact this provider via phone number 8509136960 and fax number 5733315079. The mailing address for is 801 E 6th St. Ste. 602, Panama City, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 801 E 6th St. Ste. 602, Panama City, Florida |
| Phone Number | 8509136960 |
| Fax Number | 5733315079 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1710037692 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 801 E 6th St. Ste. 602 |
|---|---|
| City | Panama City |
| State | Florida (FL) |
| Post Code | 32401 |
| Phone Number | 8509136960 |
| Fax Number | 5733315079 |
Provider's Primary Taxonomy Detail
| Speciality | Surgery |
|---|---|
| Taxonomy | 208600000X |
| Licence No | 2006023537 |
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Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1710037692 | IL | -- | |
| 165402003 | AR | -- | |
| 502944 | MO | ANTHEM BCBS | |
| 7100044890 | KY | -- | |
| 200184604 | MO | -- | |
| 761287 | HEALTHLINK | ||
| P00433989 | RAILROAD MEDICARE |
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