# 96TH MDG EGLIN AFB

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

## Provider details

- **NPI number:** 1518973908
- **Authorized official:** DR. ERIC HOLT (STAFF ANESTHESIOLOGIST)
- **Authorized official phone:** (617) 840-8249

## Contact information

- **Practice address:** 1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
- **Practice address phone:** (850) 862-1111
- **Mailing address:** 895 SANTA ROSA BLVD APT 312, FORT WALTON BEACH, FL 32548-1907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 286500000X | Military Hospital | 02002895A | IN | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 06/13/2008