Organization
GULF COAST MULTISPECIALITY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICKEY PICKLER (VICE PRESIDENT)
(850) 523-2117
Entity
Organization
Contact information
Practice address
2202 STATE AVE, SUITE 207, PANAMA CITY, FL 32405-4582
(850) 784-1856
(850) 784-1975
Mailing address
2202 STATE AVE, SUITE 207, PANAMA CITY, FL 32405-4582
(850) 784-1856
(850) 784-1975
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
07/15/2006
Last updated
10/19/2012
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