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General NPI Number Information
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NPI Number | 1437271509
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Entity Type | Organization
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Legal Business Name | DOCTORS MEDICAL CENTER OF WALTON COUNTY PA
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 21 W MAIN AVE
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City | DEFUNIAK SPRINGS
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State | FL
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Zip | 32435-2529
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Country | US
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Telephone | 850-892-2888
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Fax | 850-892-2405
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Provider Business Mailing Address
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Address Line | 21 W. MAIN AVE
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City | DEFUNIAK SPRINGS
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State | FL
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Zip | 32435
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Country | US
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Telephone | 850-892-2888
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Fax | 850-892-2405
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Authorized Official
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Title or Position | OWNER
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Name | JAMES W HOWELL
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Credential | DO
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Telephone | 850-892-2888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | OS007047
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License Number State | FL
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