Individual
MARCIA E CHURCHWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
113 LIELMANIS AVE, HURLBURT FIELD, FL 32544-5613
(850) 881-3158
Mailing address
113 ;IELMANIS AVE, HURLBURT FIELD, FL 32544
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101254948
VA
208D00000X
General Practice Physician
0101254948
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/11/2012
Last updated
12/04/2025
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