# GULF COAST MEDICAL CENTER PRIMARY CARE LLC

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

## Provider details

- **NPI number:** 1285679050
- **Authorized official:** MICKEY PICKLER (VP)
- **Authorized official phone:** (850) 229-8288

## Contact information

- **Practice address:** 2202 STATE AVE, STE. 207, PANAMA CITY, FL 32405-7601
- **Practice address phone:** (850) 784-2645
- **Practice address fax:** (850) 784-2646
- **Mailing address:** 2202 STATE AVE, STE. 207, PANAMA CITY, FL 32405-7601
- **Mailing address phone:** (850) 784-2645
- **Mailing address fax:** (850) 784-2646

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/17/2006
- **Last updated:** 05/24/2011