| Healthmark Clinic | |
|
4415 Us Highway 331 S Defuniak Springs FL 32435-6307 | |
| (850) 951-4640 | |
| (850) 892-7079 |
| Full Name | Healthmark Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 4415 Us Highway 331 S, Defuniak Springs, Florida |
| Authorized Official Name and Position | Lisa Shirley Holley (COO) |
| Authorized Official Contact | 8509514507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthmark Clinic 4415 Us Highway 331 S Defuniak Springs FL 32435-6307 Ph: (850) 951-4640 | Healthmark Clinic 4415 Us Highway 331 S Defuniak Springs FL 32435-6307 Ph: (850) 951-4640 |
| NPI Number | 1013908201 |
|---|---|
| Provider Enumeration Date | 11/04/2005 |
| Last Update Date | 09/27/2021 |
| Medicare PECOS PAC ID | 3577550045 |
|---|---|
| Medicare Enrollment ID | O20040427001088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013908201 | NPI | - | NPPES |
| 372384401 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Joseph W. Heflin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447201447 PECOS PAC ID: 6406749381 Enrollment ID: I20040204000855 |
| Provider Name | Christopher D Tanner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932151792 PECOS PAC ID: 7315937075 Enrollment ID: I20040514000400 |
| Provider Name | Christina C Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740227503 PECOS PAC ID: 2860408465 Enrollment ID: I20060306000290 |
| Provider Name | Kevin M Hornsby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619908910 PECOS PAC ID: 9537123062 Enrollment ID: I20070129000409 |
| Provider Name | John B Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528213394 PECOS PAC ID: 8628132339 Enrollment ID: I20090124000152 |
| Provider Name | Robin J Yelverton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558529164 PECOS PAC ID: 3072678275 Enrollment ID: I20090224000014 |
| Provider Name | Suzanne J Moree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790288694 PECOS PAC ID: 9032442355 Enrollment ID: I20190531000573 |
| Provider Name | Kathy Floyd Decant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427431295 PECOS PAC ID: 7113237579 Enrollment ID: I20190802001220 |
| Provider Name | Elissa Hope Purvis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194343228 PECOS PAC ID: 8022437284 Enrollment ID: I20201007002820 |
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