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Organization

DESTIN OPHTHALMOLOGY PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PRISCILLA G. FOWLER M.D. (OWNER/PROVIDER)
(850) 622-0757
Entity
Organization

Contact information

Practice address
7700 US HIGHWAY 98 W, SUITE 201, SANTA ROSA BEACH, FL 32459-3270
(850) 622-0757
(850) 622-1978
Mailing address
7700 US HIGHWAY 98 W, SUITE 201, SANTA ROSA BEACH, FL 32459-3270
(850) 622-0757
(850) 622-1978

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME90933
FL

Other

Enumeration date
07/10/2006
Last updated
03/15/2010
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