Organization
EMERALD COAST RADIATION ONCOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BUDDY ELMORE CFO (CFO/SECRETARY/TREASURER)
(850) 416-7638
Entity
Organization
Contact information
Practice address
7720 US HIGHWAY 98 W., SUITE 140, DESTIN, FL 32550-7230
(850) 622-0873
(850) 622-1912
Mailing address
PO BOX 18490, PENSACOLA, FL 32523-8490
(850) 622-0873
(850) 622-1912
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267422000
—
FL
05
—
267422000-GROUP
—
FL
Enumeration date
03/10/2006
Last updated
02/05/2010
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