Provider Demographics
NPI:1184689895
Name:MAPP, ALBERT F JR (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:F
Last Name:MAPP
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 N TYNDALL PKWY
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32404-6126
Mailing Address - Country:US
Mailing Address - Phone:850-763-5689
Mailing Address - Fax:850-913-8046
Practice Address - Street 1:489 N TYNDALL PKWY
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32404-6126
Practice Address - Country:US
Practice Address - Phone:850-763-5689
Practice Address - Fax:850-913-8046
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0047609207Q00000X
DCMD16758207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258052700Medicaid
K3368OtherMEDICARE
DA7277OtherMEDICARE RAILROAD
FL02935OtherBCBS
DA7277OtherMEDICARE RAILROAD
FL258052700Medicaid