Organization
PANHANDLE SURGICAL INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D GILMORE MD (PRESIDENT)
(850) 398-8480
Entity
Organization
Contact information
Practice address
710 HOSPITAL DR, CRESTVIEW, FL 32539-7380
(850) 398-8480
(850) 398-8482
Mailing address
710 HOSPITAL DR, CRESTVIEW, FL 32539-7380
(850) 398-8480
(850) 398-8482
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
06/23/2009
Last updated
06/23/2009
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