Organization
IVY SPINE & ORTHOPEDICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES C MCLOUGHLIN MD (OWNER)
(850) 815-7338
Entity
Organization
Contact information
Practice address
742 HARRISON AVE, PANAMA CITY, FL 32401-2524
(765) 635-1104
Mailing address
742 HARRISON AVE, PANAMA CITY, FL 32401-2524
(850) 628-7679
(850) 257-8099
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME100011
FL
Other
Enumeration date
04/04/2018
Last updated
09/07/2021
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