Organization
HUGHSTON CLINIC SOUTHEAST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA FROMKIN (CRED COORD)
(706) 494-3071
Entity
Organization
Contact information
Practice address
341 RACETRACK RD NW STE C, FORT WALTON BEACH, FL 32547-1552
(850) 226-8112
(850) 362-6068
Mailing address
6262 VETERANS PKWY, COLUMBUS, GA 31909-3540
(706) 494-3071
(706) 494-3008
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
FL
Other
Enumeration date
06/29/2017
Last updated
08/18/2023
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