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General NPI Number Information
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NPI Number | 1598930679
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Entity Type | Organization
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Legal Business Name | PANHANDLE FAMILY CARE ASSOCIATES INC
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 08/20/2015
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Provider Practice Location Address
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Address Line | 4284 KELSON AVE
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City | MARIANNA
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State | FL
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Zip | 32446-2948
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Country | US
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Telephone | 850-482-2910
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Fax | 850-482-2836
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Provider Business Mailing Address
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Address Line | 4284 KELSON AVE
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City | MARIANNA
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State | FL
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Zip | 32446-2948
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Country | US
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Telephone | 850-482-2910
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Fax | 850-482-2836
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Authorized Official
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Title or Position | MD
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Name | JOHN A SPENCE
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Credential |
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Telephone | 850-482-2910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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