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General NPI Number Information
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NPI Number | 1578834578
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Entity Type | Organization
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Legal Business Name | DAVID B. HURST M.D., P.A.
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 615 N BONITA AVE
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City | PANAMA CITY
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State | FL
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Zip | 32401-3623
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Country | US
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Telephone | 850-747-1511
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Fax |
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Provider Business Mailing Address
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Address Line | 615 N BONITA AVE
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City | PANAMA CITY
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State | FL
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Zip | 32401-3623
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Country | US
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Telephone | 850-747-1511
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID B. HURST
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Credential | M.D.
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Telephone | 850-763-0036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 54431
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License Number State | FL
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