| Memory Disorder Clinic | |
|
8391 N Davis Hwy Pensacola FL 32514-6048 | |
| (850) 494-6497 | |
| (850) 494-4993 |
| Full Name | Memory Disorder Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 8391 N Davis Hwy, Pensacola, Florida |
| Authorized Official Name and Position | Randy Butler (CFO) |
| Authorized Official Contact | 8504944125 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Memory Disorder Clinic 8391 N Davis Hwy Pensacola FL 32514-6048 Ph: (850) 494-6497 | Memory Disorder Clinic 8391 N Davis Hwy Pensacola FL 32514-6048 Ph: (850) 494-6497 |
| NPI Number | 1174578579 |
|---|---|
| Provider Enumeration Date | 05/23/2006 |
| Last Update Date | 03/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174578579 | NPI | - | NPPES |
| 058327801 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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