| Wayne P Justice M D P A | |
|
1003 College Blvd W Ste 2 Niceville FL 32578-1069 | |
| (850) 678-0443 | |
| (850) 678-7999 |
| Full Name | Wayne P Justice M D P A |
|---|---|
| Speciality | Clinic/Center |
| Location | 1003 College Blvd W Ste 2, Niceville, Florida |
| Authorized Official Name and Position | Wayne P Justice (PRESIDENT) |
| Authorized Official Contact | 8506780443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne P Justice M D P A 1003 College Blvd W Ste 2 Niceville FL 32578-1069 Ph: (850) 678-0443 | Wayne P Justice M D P A 1003 College Blvd W Ste 2 Niceville FL 32578-1069 Ph: (850) 678-0443 |
| NPI Number | 1528397791 |
|---|---|
| Provider Enumeration Date | 12/16/2009 |
| Last Update Date | 06/14/2010 |
| Medicare PECOS PAC ID | 5698805588 |
|---|---|
| Medicare Enrollment ID | O20100621000362 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528397791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Deborah L Hewitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346412632 PECOS PAC ID: 2264503648 Enrollment ID: I20080611000881 |
| Provider Name | Wayne P Justice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487624201 PECOS PAC ID: 5496885386 Enrollment ID: I20100621000528 |
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