Provider Demographics
NPI:1376521757
Name:BAY EMERGENCY PHYSICIAN SPECIALISTS INC
Entity Type:Organization
Organization Name:BAY EMERGENCY PHYSICIAN SPECIALISTS INC
Other - Org Name:BAY HYPERBARIC PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:EPSTIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACEP
Authorized Official - Phone:850-747-6046
Mailing Address - Street 1:PO BOX 466
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-0466
Mailing Address - Country:US
Mailing Address - Phone:850-747-6046
Mailing Address - Fax:850-769-2366
Practice Address - Street 1:615 N BONITA AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3623
Practice Address - Country:US
Practice Address - Phone:850-747-6046
Practice Address - Fax:850-769-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33656OtherBCBS
FL=========OtherTRICARE
D31348Medicare UPIN
33656Medicare ID - Type Unspecified
33656AMedicare ID - Type Unspecified