Individual
EDMOND JOHN DOUGLAS FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
307 BOATNER RD, EGLIN AFB, FL 32542-1302
(850) 883-8115
Mailing address
307 BOATNER RD, EGLIN AFB, FL 32542-1302
(850) 883-8115
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS17931
FL
207R00000X
Internal Medicine Physician
OS17931
FL
2083A0100X
Aerospace Medicine Physician
OS17931
FL
Other
Enumeration date
03/29/2018
Last updated
08/27/2025
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