| Emerald Coast Gastroenterology | |
|
2202 State Ave Suite 301 Panama City FL 32405-7601 | |
| (850) 215-7071 | |
| (850) 215-7073 |
| Full Name | Emerald Coast Gastroenterology |
|---|---|
| Speciality | Internal Medicine |
| Location | 2202 State Ave, Panama City, Florida |
| Authorized Official Name and Position | Grace Klin (OFFICE MANAGER) |
| Authorized Official Contact | 8502157071 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Coast Gastroenterology 2202 State Ave Suite 301 Panama City FL 32405-7601 Ph: (850) 215-7071 | Emerald Coast Gastroenterology 2202 State Ave Suite 301 Panama City FL 32405-7601 Ph: (850) 215-7071 |
| NPI Number | 1508021684 |
|---|---|
| Provider Enumeration Date | 07/28/2008 |
| Last Update Date | 09/23/2008 |
| Medicare PECOS PAC ID | 5991862724 |
|---|---|
| Medicare Enrollment ID | O20090324000209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508021684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | ME85851 (Florida) | Primary |
| Provider Name | Mariusz J Klin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457357006 PECOS PAC ID: 6507923414 Enrollment ID: I20090320000233 |
| Provider Name | Lynda J Drinkard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417276007 PECOS PAC ID: 7416143474 Enrollment ID: I20101202000432 |
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