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114 Airport Rd Ste B Panama City FL 32405-4738 | |
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| Not Available |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 114 Airport Rd Ste B, Panama City, Florida |
| Authorized Official Name and Position | Steven L Mullis (PRESIDENT) |
| Authorized Official Contact | 8507850788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
114 Airport Rd Ste B Panama City FL 32405-4738 Ph: (850) 785-0788 | 114 Airport Rd Ste B Panama City FL 32405-4738 Ph: () - |
| NPI Number | 1922029537 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 12/03/2024 |
| Medicare PECOS PAC ID | 6709854094 |
|---|---|
| Medicare Enrollment ID | O20040923001092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922029537 | NPI | - | NPPES |
| 37832 | Other | FL | BCBS FLORIDA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Steven L Mullis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912968512 PECOS PAC ID: 7618945916 Enrollment ID: I20040924000252 |
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