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General NPI Number Information
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NPI Number | 1245443829
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Entity Type | Organization
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Legal Business Name | FT. WALTON BEACH ANESTHESIA SERVICES LLC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 01/28/2009
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Provider Practice Location Address
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Address Line | 1000 MARWALT DRIVE ATTN ALLEN KERCHER
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City | FT. WALTON BEACH
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State | FL
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Zip | 32547-6039
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Country | US
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Telephone | 850-375-2395
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Fax | 866-471-1940
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Provider Business Mailing Address
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Address Line | 1000 MARWALT DRIVE ATTN ALLEN KERSHER
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City | FT. WALTON BEAC
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State | FL
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Zip | 32547-6039
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Country | US
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Telephone | 850-375-2395
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Fax | 866-417-1940
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Authorized Official
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Title or Position | DIRECTOR
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Name | ALLEN W KERCHER
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Credential |
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Telephone | 850-474-8155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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