Organization
BEACHES FAMILY PRACTICE CENTER
Active
Parent organization
BEACHES FAMILY PRACTICE CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEACHES FAMILY PRACTICE CENTER
Authorized official
DR. ERNEST GEORGE HASLAM M.D. (PHYSICIAN)
(850) 234-8811
Entity
Organization
Contact information
Practice address
230 S HIGHWAY 79, PANAMA CITY, FL 32413-2151
(850) 234-8811
(850) 234-8556
Mailing address
230 S HIGHWAY 79, PANAMA CITY, FL 32413-2151
(850) 234-8811
(850) 234-8556
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME26512
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3806
FLORIDA MEDICARE
FL
01
—
76011
BLUE CROSS
FL
Enumeration date
01/29/2007
Last updated
01/28/2008
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