Provider Demographics
NPI:1336365881
Name:R AND S PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:R AND S PROFESSIONAL CORPORATION
Other - Org Name:DFS WALK IN CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANWAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOWDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-951-1800
Mailing Address - Street 1:9 W ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:DEFUNIAK SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32435-2301
Mailing Address - Country:US
Mailing Address - Phone:850-951-1800
Mailing Address - Fax:850-951-1800
Practice Address - Street 1:9 W ORANGE AVE
Practice Address - Street 2:
Practice Address - City:DEFUNIAK SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32435-2301
Practice Address - Country:US
Practice Address - Phone:850-951-1800
Practice Address - Fax:850-951-1800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health