Organization
DESTIN SURGERY CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES A MOODY M.D. (PHYSICIAN/OWNER)
(850) 837-8831
Entity
Organization
Contact information
Practice address
415 MOUNTAIN DRIVE, SUITE # 6, DESTIN, FL 32541
(850) 837-8831
(850) 837-9137
Mailing address
P.O. BOX 368, DESTIN, FL 32540
(850) 837-8831
(850) 837-9137
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0052108
FL
Other
Enumeration date
10/20/2010
Last updated
10/20/2010
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