Ft. Walton Beach General Surgery LLC

NPI #1194769950 in Ft Walton Beach, Florida

Provider Information

NPI Number: 1194769950
Entity Type: Organization
Organization Name: Ft. Walton Beach General Surgery LLC
Primary Specialty: Surgery
Enumeration Date: Jun 15, 2006
Last Updated: Sep 11, 2007

Practice Location

Address: 1775 LEWIS TURNER BLVD
Address 2: #102
City: Ft Walton Beach
State: Florida
ZIP Code: 32547-1221
Phone: (850) 864-3232

Authorized Official

Name: MICKEY PICKLER
Title: VP
Phone: (850) 864-3232

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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