Organization
FT WALTON BEACH INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICKEY PICKLER (VP)
(850) 523-2117
Entity
Organization
Contact information
Practice address
1032 MAR WALT DR, SUITE 230, FORT WALTON BEACH, FL 32547-6645
(850) 862-0318
(850) 862-2887
Mailing address
1032 MAR WALT DR, SUITE 230, FORT WALTON BEACH, FL 32547-6645
(850) 862-0318
(850) 862-2887
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/23/2006
Last updated
06/23/2008
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