Organization
STONE SURGERY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAWZI FAWAZ M.D. (OWNER)
(850) 951-8800
Entity
Organization
Contact information
Practice address
962 US 331 SOUTH, DEFUNIAK SPRINGS, FL 32435
(950) 951-8800
(950) 951-0203
Mailing address
962 US HWY 331 SOUTH, DEFUNIAK SPRINGS, FL 32435
(950) 951-8800
(950) 951-0203
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
82523
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932283389
NPI FOR SS#
FL
05
—
261312300
—
FL
Enumeration date
03/16/2007
Last updated
02/23/2009
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