| Tms Of Emerald Coast | |
|
403 Hollywood Blvd Nw Ste 103a Fort Walton Beach FL 32548-4531 | |
| (801) 245-0577 | |
| Not Available |
| Full Name | Tms Of Emerald Coast |
|---|---|
| Speciality | Clinic/Center |
| Location | 403 Hollywood Blvd Nw Ste 103a, Fort Walton Beach, Florida |
| Authorized Official Name and Position | Mindy Mcclellan (OWNER) |
| Authorized Official Contact | 8012450577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tms Of Emerald Coast 403 Hollywood Blvd Nw Ste 103a Fort Walton Beach FL 32548-4531 Ph: (801) 245-0577 | Tms Of Emerald Coast 403 Hollywood Blvd Nw Ste 103a Fort Walton Beach FL 32548-4531 Ph: (801) 245-0577 |
| NPI Number | 1356104269 |
|---|---|
| Provider Enumeration Date | 02/02/2024 |
| Last Update Date | 02/15/2024 |
| Certification Date | 02/15/2024 |
| Medicare PECOS PAC ID | 3274972740 |
|---|---|
| Medicare Enrollment ID | O20240416003946 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356104269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | James L Igleburger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376504118 PECOS PAC ID: 3678593530 Enrollment ID: I20061207000020 |
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