| Marianne L Mccain Ph D P A | |
|
118 Truxton Ave Fort Walton Beach FL 32547-2461 | |
| (850) 664-7690 | |
| (850) 664-7691 |
| Full Name | Marianne L Mccain Ph D P A |
|---|---|
| Speciality | Psychologist |
| Location | 118 Truxton Ave, Fort Walton Beach, Florida |
| Authorized Official Name and Position | Marianne Lisa Mccain (PRESIDENT) |
| Authorized Official Contact | 8506647690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marianne L Mccain Ph D P A 118 Truxton Ave Fort Walton Beach FL 32547-2461 Ph: (850) 664-7690 | Marianne L Mccain Ph D P A 118 Truxton Ave Fort Walton Beach FL 32547-2461 Ph: (850) 664-7690 |
| NPI Number | 1467626614 |
|---|---|
| Provider Enumeration Date | 04/18/2008 |
| Last Update Date | 04/18/2008 |
| Medicare PECOS PAC ID | 8123106945 |
|---|---|
| Medicare Enrollment ID | O20080419000048 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467626614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY0004162 (Florida) | Primary |
| Provider Name | Marianne L Mccain |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699749846 PECOS PAC ID: 7315025244 Enrollment ID: I20080417000489 |
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