Individual
MR. TWAN PHANIJPHAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1326 LEWIS TURNER BLVD, FORT WALTON BEACH, FL 32547-1139
(850) 601-8177
(850) 862-0605
Mailing address
1326 LEWIS TURNER BLVD, FORT WALTON BEACH, FL 32547-1139
(850) 601-8177
(850) 862-0605
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
2010014123
MO
207RG0100X
Gastroenterology Physician
5101015350
MI
207RG0100X
Gastroenterology Physician
Primary
OS16137
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156440050
MEDICARE PTAN #
MO
Enumeration date
04/03/2007
Last updated
07/22/2025
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