Emerald Coast Surgical Specialists Pa

LBN: Emerald Coast Surgical Specialists Pa
Emerald Coast Surgical Specialists Pa is an health care organization with primary practice located at 5992 Berryhill Road 203, Milton FL 32570. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as the primary health care specialty. Emerald Coast Surgical Specialists Pa can be contacted via phone (850) 626-2131, or through Mckissack, Randall L via phone (850) 626-2131.

Contact Information

Primary practice address
5992 Berryhill Road 203 Milton FL 32570
Phone: (850) 626-2131
Fax: (850) 626-2133
Website:
Map and Directions
Authorized official contact:
Name: Mckissack, Randall L Doctor of Medicine (MD)
Phone: (850) 626-2131

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X

Profile Details

NPI number 1750565768
LBN Legal business name Emerald Coast Surgical Specialists Pa
DBA Doing business as
Authorized official Mckissack, Randall L Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 27th, 2007
Last updated May 30th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750565768 NPPES
Florida MEDICAID 277632400

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