| Mtm Specialist | |
|
123 J Harvey Ethridge St Bonifay FL 32425-2104 | |
| (850) 591-9694 | |
| Not Available |
| Full Name | Mtm Specialist |
|---|---|
| Speciality | Family Medicine |
| Location | 123 J Harvey Ethridge St, Bonifay, Florida |
| Authorized Official Name and Position | Mark Byington (MANAGER) |
| Authorized Official Contact | 8505919694 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mtm Specialist 1423 Conservancy Dr E Tallahassee FL 32312-6772 | Mtm Specialist 123 J Harvey Ethridge St Bonifay FL 32425-2104 Ph: (850) 591-9694 |
| NPI Number | 1467188953 |
|---|---|
| Provider Enumeration Date | 07/27/2022 |
| Last Update Date | 03/08/2023 |
| Certification Date | 03/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467188953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 3336C0002X | Pharmacy - Clinic Pharmacy | () | Secondary |
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