Healthcare Provider Details

I. General information

NPI: 1205270089
Provider Name (Legal Business Name): DILLAHUNTY EMERGENCY PHYSICIANS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 W MILLER ST
DILLEY TX
78017-3818
US

IV. Provider business mailing address

815 S PALAFOX ST STE. 300
PENSACOLA FL
32502-5960
US

V. Phone/Fax

Practice location:
  • Phone: 830-965-2003
  • Fax:
Mailing address:
  • Phone: 800-444-7009
  • Fax: 800-305-3233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH H GATEWOOD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 800-444-7009