Healthcare Provider Details

I. General information

NPI: 1396766911
Provider Name (Legal Business Name): BAY FAMILY MEDICINE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 JENKS AVE SUITE 5
PANAMA CITY FL
32405-4909
US

IV. Provider business mailing address

PO BOX 97
LYNN HAVEN FL
32444-0097
US

V. Phone/Fax

Practice location:
  • Phone: 850-763-3635
  • Fax: 850-763-4448
Mailing address:
  • Phone: 850-763-3635
  • Fax: 850-763-4448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME92110
License Number StateFL

VIII. Authorized Official

Name: DR. STEPHEN H ARMISTEAD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 850-763-3635