| Emerald Coast Mood & Memory Pa | |
|
922 Mar Walt Dr Suite 100 Fort Walton Beach FL 32547-6630 | |
| (850) 226-4785 | |
| Not Available |
| Full Name | Emerald Coast Mood & Memory Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 922 Mar Walt Dr, Fort Walton Beach, Florida |
| Authorized Official Name and Position | James Louis Igleburger (PRESIDENT OWNER) |
| Authorized Official Contact | 8502264785 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Coast Mood & Memory Pa 922 Mar Walt Dr Suite 100 Fort Walton Beach FL 32547-6630 Ph: (850) 226-4785 | Emerald Coast Mood & Memory Pa 922 Mar Walt Dr Suite 100 Fort Walton Beach FL 32547-6630 Ph: (850) 226-4785 |
| NPI Number | 1710097704 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710097704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ME 94223 (Florida) | Primary |
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