Provider Demographics
NPI:1013455609
Name:PENSACOLA CARDIOLOGY, PA
Entity Type:Organization
Organization Name:PENSACOLA CARDIOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:DOTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-433-3300
Mailing Address - Street 1:4700 BAYOU BLVD
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2698
Mailing Address - Country:US
Mailing Address - Phone:850-433-3300
Mailing Address - Fax:850-433-9709
Practice Address - Street 1:4700 BAYOU BLVD
Practice Address - Street 2:SUITE 2B
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2698
Practice Address - Country:US
Practice Address - Phone:850-433-3300
Practice Address - Fax:850-433-9709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1013455609OtherNPI