# SOUTHERN EYE SPECIALISTS PC

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

## Provider details

- **NPI number:** 1376774018
- **Authorized official:** DR. ANDREW FREDERIC DANNEMANN MD (MD/PRESIDENT)
- **Authorized official phone:** (850) 784-3937

## Contact information

- **Practice address:** 2500 MARTIN LUTHER KING JR BLVD, PANAMA CITY, FL 32405-4412
- **Practice address phone:** (850) 784-3937
- **Practice address fax:** (851) 522-9829
- **Mailing address:** PO BOX 8863, DOTHAN, AL 36304-0863
- **Mailing address phone:** (850) 784-3937
- **Mailing address fax:** (851) 522-9829

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME63970 | FL | Yes |

## Other

- **Enumeration date:** 07/29/2009
- **Last updated:** 07/29/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | PENDING | — | FL |