# THOMAS C. CHURCH M.D., PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114948387
- **Authorized official:** THOMAS CHURCH (DIRECTOR)
- **Authorized official phone:** (850) 244-1157

## Contact information

- **Practice address:** 51 YACHT CLUB DR NE, FORT WALTON BEACH, FL 32548-4473
- **Practice address phone:** (850) 244-1157
- **Mailing address:** 51 YACHT CLUB DR NE, FORT WALTON BEACH, FL 32548-4473
- **Mailing address phone:** (850) 244-1157

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME0016848 | FL | Yes |

## Other

- **Enumeration date:** 07/22/2006
- **Last updated:** 04/12/2010