| Magnolia Medical Clinic P.a. | |
|
319 Green Acres Rd Ste 101 Fort Walton Beach FL 32547 | |
| (850) 243-7681 | |
| (850) 243-0471 |
| Full Name | Magnolia Medical Clinic P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 319 Green Acres Rd Ste 101, Fort Walton Beach, Florida |
| Authorized Official Name and Position | Crystal Weatherington (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 8502430520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Medical Clinic P.a. 319 Green Acres Rd Ste 101 Fort Walton Beach FL 32547-1170 Ph: (850) 243-7681 | Magnolia Medical Clinic P.a. 319 Green Acres Rd Ste 101 Fort Walton Beach FL 32547 Ph: (850) 243-7681 |
| NPI Number | 1639281652 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 03/10/2025 |
| Medicare PECOS PAC ID | 8325185473 |
|---|---|
| Medicare Enrollment ID | O20091022000578 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639281652 | NPI | - | NPPES |
| 254841100 | Medicaid | FL | |
| CH5541 | Other | FL | RAIL ROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | John D Sites |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043322159 PECOS PAC ID: 7012054166 Enrollment ID: I20091023000146 |
| Provider Name | Chris George Pappas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245273267 PECOS PAC ID: 7517114366 Enrollment ID: I20120829000637 |
| Provider Name | Lindsey A Mann-badyrka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457766214 PECOS PAC ID: 2163743386 Enrollment ID: I20150530000049 |
| Provider Name | Teresa Marie Skojac |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154393700 PECOS PAC ID: 8325292170 Enrollment ID: I20160420000410 |
| Provider Name | Christopher P Paulson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265428171 PECOS PAC ID: 2860647385 Enrollment ID: I20170720000065 |
| Provider Name | Brandy Marie Lackey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558876656 PECOS PAC ID: 9537429840 Enrollment ID: I20180206002138 |
| Provider Name | Grant Eugene Zachary |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982054391 PECOS PAC ID: 6800120312 Enrollment ID: I20190702002540 |
| Provider Name | Emily Christine Mcdevitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881892446 PECOS PAC ID: 3779649199 Enrollment ID: I20200806002098 |
| Provider Name | John E Loudermilk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780996918 PECOS PAC ID: 1658514450 Enrollment ID: I20210408002772 |
| Provider Name | Lindsay R Herndon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366061343 PECOS PAC ID: 2264855006 Enrollment ID: I20230629002519 |
| Provider Name | Keilah M Barton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659931962 PECOS PAC ID: 5496137200 Enrollment ID: I20250109003011 |
Coastline Medical Services Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1817 Lewis Turner Blvd Ste F, Fort Walton Beach, FL 32547 Phone: 850-396-1110 | |
Family Medicine Associates Of The Emerald Coast P A Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 348 Miracle Strip Pkwy Sw, Suite 23, Fort Walton Beach, FL 32548 Phone: 850-269-2186 Fax: 850-269-2341 | |
James P Wilson Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 Cloverdale Blvd, Fort Walton Beach, FL 32547 Phone: 850-862-7604 Fax: 850-862-8156 | |
Glass Inpatient Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-862-1111 | |
Nw Florida Lung Associates, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 322 Racetrack Rd Ne, Fort Walton Beach, FL 32547 Phone: 850-863-3000 Fax: 850-374-3200 | |
White-wilson Medical Center, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1005 Mar Walt Dr, Fp Department, Fort Walton Beach, FL 32547 Phone: 850-863-6600 Fax: 850-862-0977 | |
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