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General NPI Number Information
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NPI Number | 1023685302
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Entity Type | Organization
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Legal Business Name | PANHANDLE ANESTHESIA SERVICES
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 5330 N DAVIS HWY
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City | PENSALOCA
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State | FL
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Zip | 35203
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Country | US
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Telephone | 850-447-8874
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Fax | 850-477-8865
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Provider Business Mailing Address
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Address Line | 5330 N DAVIS HWY
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City | PENSALOCA
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State | FL
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Zip | 35203
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Country | US
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Telephone | 850-447-8874
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Fax | 850-477-8865
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Authorized Official
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Title or Position | OWNER
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Name | PHILIP RENFROE
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Credential |
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Telephone | 850-477-8874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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