# BLUEWATER ORTHOPEDICS PA

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

## Provider details

- **NPI number:** 1417989617
- **Authorized official:** DR. THOMAS M. FOX D.O. (PRESIDENT)
- **Authorized official phone:** (850) 897-8081

## Contact information

- **Practice address:** 1950 BLUEWATER BLVD, SUITE 100, NICEVILLE, FL 32578-3887
- **Practice address phone:** (850) 897-8081
- **Practice address fax:** (850) 897-1520
- **Mailing address:** 1950 BLUEWATER BLVD, SUITE 100, NICEVILLE, FL 32578-3887
- **Mailing address phone:** (850) 897-8081
- **Mailing address fax:** (850) 897-1520

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/07/2006
- **Last updated:** 03/02/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 250939300 | — | FL |