325 MDG

Psychologist · Tyndall Afb, FL

Organization Active NPI

NPI number 1568436962

Practice location

325 MDG Bldg
1305 Suwannee Ave
Tyndall Afb, FL 32403
Phone
(850) 283-7511
Fax
(850) 283-7721

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NPI record

NPI
1568436962
Entity type
Organization (Type 2)
Enumeration date
February 14, 2006
Last updated
June 13, 2008
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Psychologist Primary 103T00000X PY5848 FL

Mailing address

2405 Maple Ct
Panama City, FL 32404-3047
Phone
(850) 283-7511
Fax
(850) 283-7721

Authorized official

Name
Dr. George Nicholas Jr.
Title
325 MDG Commander
Phone
(850) 283-7515

About 325 MDG

325 MDG is a healthcare organization registered in the NPI registry with the primary taxonomy Psychologist (code 103T00000X). The practice location is 325 MDG Bldg, 1305 Suwannee Ave, Tyndall Afb, FL 32403. The NPI number 1568436962 was assigned on February 14, 2006 and the record was last updated on June 13, 2008.

325 MDG lists a license in the registry: #PY5848 (FL) for Psychologist. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Dr. George Nicholas Jr., 325 MDG Commander.

Frequently asked questions

What is the NPI number of 325 MDG?

The NPI number is 1568436962.

What is the phone number of 325 MDG?

The phone number listed for the practice location is (850) 283-7511.

Where is 325 MDG located?

325 MDG Bldg, 1305 Suwannee Ave, Tyndall Afb, FL 32403.

What is the taxonomy code for 325 MDG?

The primary taxonomy code is 103T00000X – Psychologist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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