| South Walton Medical Center Inc | |
|
10005c Us Highway 98 W Destin FL 32550-4962 | |
| (850) 837-8005 | |
| (850) 837-4352 |
| Full Name | South Walton Medical Center Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 10005c Us Highway 98 W, Destin, Florida |
| Authorized Official Name and Position | Ronald Bruce Causton (OWNER/PHYSICIAN) |
| Authorized Official Contact | 8508378005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Walton Medical Center Inc 10005c Us Highway 98 W Destin FL 32550-4962 Ph: (850) 837-8005 | South Walton Medical Center Inc 10005c Us Highway 98 W Destin FL 32550-4962 Ph: (850) 837-8005 |
| NPI Number | 1659541340 |
|---|---|
| Provider Enumeration Date | 03/10/2008 |
| Last Update Date | 02/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659541340 | NPI | - | NPPES |
| 265468700 | Medicaid | FL | |
| 46168 | Other | FL | BC BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | FLME43330 (Florida) | Primary |
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