# HUGHSTON CLINIC SOUTHEAST PC

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

## Provider details

- **NPI number:** 1598286684
- **Authorized official:** AMANDA FROMKIN (CRED COORD)
- **Authorized official phone:** (706) 494-3071

## Contact information

- **Practice address:** 341 RACETRACK RD NW STE C, FORT WALTON BEACH, FL 32547-1552
- **Practice address phone:** (850) 226-8112
- **Practice address fax:** (850) 362-6068
- **Mailing address:** 6262 VETERANS PKWY, COLUMBUS, GA 31909-3540
- **Mailing address phone:** (706) 494-3071
- **Mailing address fax:** (706) 494-3008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | FL | Yes |

## Other

- **Enumeration date:** 06/29/2017
- **Last updated:** 08/18/2023