Organization
EMERALD COAST MOOD & MEMORY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LOUIS IGLEBURGER MD (PRESIDENT OWNER)
(850) 226-4785
Entity
Organization
Contact information
Practice address
922 MAR WALT DR, SUITE 100, FORT WALTON BEACH, FL 32547-6630
(850) 226-4785
Mailing address
922 MAR WALT DR, SUITE 100, FORT WALTON BEACH, FL 32547-6630
(850) 226-4785
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME 94223
FL
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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