| Midway Medical Clinic Ii | |
|
201 Forest Park Cir Panama City FL 32405-4916 | |
| (850) 248-7777 | |
| (850) 248-7779 |
| Full Name | Midway Medical Clinic Ii |
|---|---|
| Speciality | General Practice |
| Location | 201 Forest Park Cir, Panama City, Florida |
| Authorized Official Name and Position | Raun D Skyrm (ADMINISTRATOR) |
| Authorized Official Contact | 3307733544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midway Medical Clinic Ii 201 Forest Park Cir Panama City FL 32405-4916 Ph: (850) 248-7777 | Midway Medical Clinic Ii 201 Forest Park Cir Panama City FL 32405-4916 Ph: (850) 248-7777 |
| NPI Number | 1285038117 |
|---|---|
| Provider Enumeration Date | 10/21/2014 |
| Last Update Date | 10/21/2014 |
| Medicare PECOS PAC ID | 1557683521 |
|---|---|
| Medicare Enrollment ID | O20141202000503 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285038117 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | ME108352 (Florida) | Primary |
| Provider Name | Amy C Lippincott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487817367 PECOS PAC ID: 3476620329 Enrollment ID: I20080918000694 |
| Provider Name | Ata Ulhaq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215912068 PECOS PAC ID: 8325943749 Enrollment ID: I20121015000140 |
| Provider Name | Erica Shanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952875254 PECOS PAC ID: 0547508574 Enrollment ID: I20190215002106 |
| Provider Name | Katie M Huckaby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245648542 PECOS PAC ID: 9436452356 Enrollment ID: I20190225000111 |
| Provider Name | Aaron C Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346723228 PECOS PAC ID: 6002155439 Enrollment ID: I20190304000089 |
| Provider Name | Bruce Franklin Ferris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932752276 PECOS PAC ID: 9032533153 Enrollment ID: I20200722002768 |
| Provider Name | Christina Faye Trent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164160628 PECOS PAC ID: 6507249042 Enrollment ID: I20220817000809 |
| Provider Name | Monyce Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275015984 PECOS PAC ID: 4284090416 Enrollment ID: I20230515000685 |
| Provider Name | Jacolbia Vanice Bush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528747094 PECOS PAC ID: 0244687812 Enrollment ID: I20231103002799 |
| Provider Name | Solomon Wolff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457137929 PECOS PAC ID: 9032566039 Enrollment ID: I20231113003617 |
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