# IVY SPINE & ORTHOPEDICS, LLC

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

## Provider details

- **NPI number:** 1215433644
- **Authorized official:** JAMES C MCLOUGHLIN MD (OWNER)
- **Authorized official phone:** (850) 815-7338

## Contact information

- **Practice address:** 742 HARRISON AVE, PANAMA CITY, FL 32401-2524
- **Practice address phone:** (765) 635-1104
- **Mailing address:** 742 HARRISON AVE, PANAMA CITY, FL 32401-2524
- **Mailing address phone:** (850) 628-7679
- **Mailing address fax:** (850) 257-8099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | ME100011 | FL | Yes |

## Other

- **Enumeration date:** 04/04/2018
- **Last updated:** 09/07/2021