| John Axley M D P A | |
|
4400 Bayou Blvd Ste 43 Pensacola FL 32503-1910 | |
| (850) 477-3015 | |
| (850) 477-3026 |
| Full Name | John Axley M D P A |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4400 Bayou Blvd Ste 43, Pensacola, Florida |
| Authorized Official Name and Position | John Axley (M.D.) |
| Authorized Official Contact | 8504773015 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John Axley M D P A 4400 Bayou Blvd Ste 43 Pensacola FL 32503-1910 Ph: (850) 477-3015 | John Axley M D P A 4400 Bayou Blvd Ste 43 Pensacola FL 32503-1910 Ph: (850) 477-3015 |
| NPI Number | 1912070293 |
|---|---|
| Provider Enumeration Date | 11/16/2006 |
| Last Update Date | 03/20/2013 |
| Medicare PECOS PAC ID | 3577687136 |
|---|---|
| Medicare Enrollment ID | O20101026001425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912070293 | NPI | - | NPPES |
| DE7927 | Other | RRB PTAN | |
| 529918810 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME20237 (Florida) | Primary |
| Provider Name | Debra Kay Axley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184797458 PECOS PAC ID: 8820113038 Enrollment ID: I20100910001117 |
| Provider Name | John Harold Axley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164595427 PECOS PAC ID: 4486778040 Enrollment ID: I20101020001357 |
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