MEDICARE: PANAMA CITY INFECTIOUS DISEASE ASSOCIATES PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	94925	OTHER	FL	BCBS OF FLORIDA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245208735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PANAMA CITY INFECTIOUS DISEASE ASSOCIATES PA

Provider Business Mailing Address
First Line	:	2579 HUNTCLIFF LN
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4902
Country	:	US
Telephone Number	:	850-763-8596
Fax Number	:	850-784-6774

Provider Business Practice Location Address
First Line	:	2579 HUNTCLIFF LN
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4902
Country	:	US
Telephone Number	:	850-763-8596
Fax Number	:	850-784-6774

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	WILLIAM D BONE
Credential	:	M.D.
Telephone Number	:	850-763-8596

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	09/08/2010

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