Destin Surgery Clinic, P.a.

NPI #1457661605 in Destin, Florida

Provider Information

NPI Number: 1457661605
Entity Type: Organization
Organization Name: Destin Surgery Clinic, P.a.
Primary Specialty: Specialist
Enumeration Date: Oct 20, 2010
Last Updated: Oct 20, 2010

Practice Location

Address: 415 MOUNTAIN DRIVE
Address 2: SUITE # 6
City: Destin
State: Florida
ZIP Code: 32541
Phone: (850) 837-8831

Authorized Official

Name: JAMES A MOODY, M.D.
Title: PHYSICIAN/OWNER
Phone: (850) 837-8831

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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