Organization
NEW AGE BIOMEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MARK FANNIN MD (MEMBER/MANAGER/PRESIDENT)
(850) 494-0048
Entity
Organization
Contact information
Practice address
4600 N DAVIS HWY, STE 253, PENSACOLA, FL 32503-2337
(850) 494-0048
Mailing address
PO BOX 116422, ATLANTA, GA 30368-6422
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
02/22/2010
Last updated
10/06/2011
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