MEDICARE: ANESTHESIA AND PAIN CONSULTANTS 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	174400000X	Specialist

General Provider Information

NPI Number	:	1316986235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANESTHESIA AND PAIN CONSULTANTS PA

Provider Business Mailing Address
First Line	:	PO BOX 640
Second Line	:
City	:	CRESTVIEW
State	:	FL
Zip	:	32536-0640
Country	:	US
Telephone Number	:	850-758-7708
Fax Number	:	850-682-7977

Provider Business Practice Location Address
First Line	:	7800 US HIGHWAY 98 W
Second Line	:
City	:	DESTIN
State	:	FL
Zip	:	32550-7228
Country	:	US
Telephone Number	:	850-758-7708
Fax Number	:	850-682-7977

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	DR. KARY VAN ALLEN
Credential	:	DO
Telephone Number	:	850-758-7708

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	08/22/2020

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Directions to “ANESTHESIA AND PAIN CONSULTANTS PA ” Practice Location

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