Organization
SOUTHERN EYE SPECIALISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW FREDERIC DANNEMANN MD (MD/PRESIDENT)
(850) 784-3937
Entity
Organization
Contact information
Practice address
2500 MARTIN LUTHER KING JR BLVD, PANAMA CITY, FL 32405-4412
(850) 784-3937
(851) 522-9829
Mailing address
PO BOX 8863, DOTHAN, AL 36304-0863
(850) 784-3937
(851) 522-9829
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME63970
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
07/29/2009
Last updated
07/29/2009
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