Organization
MULLIS EYE INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN PAYNE MD (VICE PRESIDENT)
(850) 763-6666
Entity
Organization
Contact information
Practice address
1600 JENKS AVE, PANAMA CITY, FL 32405-4644
(850) 763-6666
(850) 763-6665
Mailing address
1600 JENKS AVENUE, PANAMA CITY, FL 32405
(850) 763-6666
(850) 763-6665
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251263700
—
FL
05
—
301351100
—
FL
Enumeration date
03/14/2007
Last updated
11/14/2012
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