MEDICARE: DR. WILLIAM J FLYNN M.D.,P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME46709	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30000	OTHER	FL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275537060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM J FLYNN M.D.,P.A.

Provider Business Mailing Address
First Line	:	2211 HARRISON AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4549
Country	:	US
Telephone Number	:	850-763-2555
Fax Number	:	850-763-9374

Provider Business Practice Location Address
First Line	:	2211 HARRISON AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4549
Country	:	US
Telephone Number	:	850-763-2555
Fax Number	:	850-763-9374

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	12/30/2009

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