| 30a Medical Incorporated | |
|
4164 W County Highway 30a Santa Rosa Beach FL 32459-4336 | |
| (850) 622-2313 | |
| (850) 622-2718 |
| Full Name | 30a Medical Incorporated |
|---|---|
| Speciality | Family Medicine |
| Location | 4164 W County Highway 30a, Santa Rosa Beach, Florida |
| Authorized Official Name and Position | Scott Thurston (OWNER) |
| Authorized Official Contact | 8506222313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 30a Medical Incorporated 4164 W County Highway 30a Santa Rosa Beach FL 32459-4336 Ph: (850) 622-2313 | 30a Medical Incorporated 4164 W County Highway 30a Santa Rosa Beach FL 32459-4336 Ph: (850) 622-2313 |
| NPI Number | 1851762991 |
|---|---|
| Provider Enumeration Date | 10/15/2015 |
| Last Update Date | 06/30/2017 |
| Medicare PECOS PAC ID | 0648572560 |
|---|---|
| Medicare Enrollment ID | O20160111000473 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851762991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Scott P Thurston |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1326257718 PECOS PAC ID: 5698704989 Enrollment ID: I20050808000183 |
| Provider Name | Thomas John |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013095603 PECOS PAC ID: 2466550710 Enrollment ID: I20070609000115 |
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