Healthcare Provider Details

I. General information

NPI: 1346865078
Provider Name (Legal Business Name): PANHANDLE OUTPATIENT SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2020
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 CREIGHTON RD STE C
PENSACOLA FL
32504-7143
US

IV. Provider business mailing address

1502 CREIGHTON RD STE C
PENSACOLA FL
32504-7143
US

V. Phone/Fax

Practice location:
  • Phone: 561-630-6277
  • Fax: 561-630-6062
Mailing address:
  • Phone: 850-876-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KARL THORPE
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 804-814-4378