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Organization

SURGICAL ASSOCIATES OF NORTHWEST FL PA

Active
Other names
Surgical Associates of Northwest FL PA
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD BOULWARE WILSON M.D. (PRESIDENT)
(850) 785-3232
Entity
Organization

Contact information

Practice address
740 HARRISON AVE, PANAMA CITY, FL 32401-2524
(850) 785-3232
(850) 747-8648
Mailing address
740 HARRISON AVE, PANAMA CITY, FL 32401-2524
(850) 785-3232
(850) 747-8648

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
NOT APPLICABLE
FL

Other

Enumeration date
07/09/2006
Last updated
08/22/2020
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