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Organization
PATIENTS FIRST MAHAN MEDICAL CENTER, PA
Active
Organization
PATIENTS FIRST MAHAN MEDICAL CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDRICK B. LUTZ III M.D. (PRESIDENT)
(850) 877-7164
Entity
Organization
Contact information
Practice address
1705 MAHAN DR, TALLAHASSEE, FL 32308-5201
(850) 877-7164
(850) 656-1391
Mailing address
1705 MAHAN DR, TALLAHASSEE, FL 32308-5201
(850) 877-7164
(850) 656-1391
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AH366
MEDICARE PTAN
FL
Enumeration date
07/19/2007
Last updated
05/07/2015
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