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General NPI Number Information
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NPI Number | 1205122736
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Entity Type | Individual
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Provider Name | PAMELA JAMES WARNER D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2011
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 341 RACETRACK RD NW STE C
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-1788
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Country | US
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Telephone | 850-226-8112
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Fax | 850-362-6068
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Provider Business Mailing Address
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Address Line | PO BOX 370
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City | FORTSON
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State | GA
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Zip | 31808-0370
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Country | US
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Telephone |
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Fax | 706-494-3008
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | OS14899
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License Number State | FL
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