Individual
MR. ETHAN WALLACE RHONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1619 CREIGHTON RD STE 1, PENSACOLA, FL 32504-7152
(850) 444-4700
(850) 434-8144
Mailing address
PO BOX 11037, PENSACOLA, FL 32524-1037
(850) 444-7000
(850) 444-7497
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9100907
FL
363AM0700X
Medical Physician Assistant
Primary
PA9100907
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291142600
—
FL
01
—
PA9100907
FLORIDA STATE DOH - MEDICAL LICENSURE
FL
Enumeration date
06/01/2005
Last updated
07/21/2022
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