Unknown Individual – Internal Medicine Physician, NPI 1255316394
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
1005, Mar Walt Drive, Wright, Fort Walton Beach, Okaloosa County, Florida, 32547, United States
FORT WALTON BEACH, FL 325476707
Phone: (850) 863-8100
Fax: (850) 862-2302
Type: Mailing
2001 E HIGHWAY 20
INTERNAL MEDICINE DEPARTMENT
NICEVILLE, FL 325788826
Phone: (850) 897-4400
Fax: (850) 897-0623
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32547)
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