| Vickie N Harrell Md Pa | |
|
801 E 6th Street Suite 204 Panama City FL 32401 | |
| (850) 913-0018 | |
| (850) 913-9137 |
| Full Name | Vickie N Harrell Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 801 E 6th Street, Panama City, Florida |
| Authorized Official Name and Position | Vickie N Harrell (PRESIDENT) |
| Authorized Official Contact | 8509130018 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vickie N Harrell Md Pa Po Box 1330 Lynn Haven FL 32444 Ph: (850) 913-0018 | Vickie N Harrell Md Pa 801 E 6th Street Suite 204 Panama City FL 32401 Ph: (850) 913-0018 |
| NPI Number | 1023101334 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 12/07/2011 |
| Medicare PECOS PAC ID | 3375735608 |
|---|---|
| Medicare Enrollment ID | O20101005001103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023101334 | NPI | - | NPPES |
| 31748 | Other | FL | BCBS FLORIDA |
| 379777500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME70385 (Florida) | Primary |
| Provider Name | Vickie N Harrell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730155060 PECOS PAC ID: 6507058955 Enrollment ID: I20101004001497 |
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