Southern Eye Specialists PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME63970 Issued in FL

Legal business name

SOUTHERN EYE SPECIALISTS PC

Practice address

2500 Martin Luther King Jr Blvd
Panama City, FL 32405-4412

Phone

(850) 784-3937

Fax

(851) 522-9829

NPI assigned

Jul 29, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Andrew Frederic Dannemann, MD

Title

MD/President

Phone

(850) 784-3937

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248825600000",
    "number": "1376774018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8863",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363040863",
            "telephone_number": "850-784-3937",
            "fax_number": "851-522-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MARTIN LUTHER KING JR BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054412",
            "telephone_number": "850-784-3937",
            "fax_number": "851-522-9829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN EYE SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-29",
        "last_updated": "2009-07-29",
        "status": "A",
        "authorized_official_last_name": "DANNEMANN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "FREDERIC",
        "authorized_official_title_or_position": "MD/PRESIDENT",
        "authorized_official_telephone_number": "850-784-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME63970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.