BASIL FOSSUM MD PA

FORT WALTON BEACH, FL
NPI1184594962
Entity TypeOrganization
Authorized ContactJENNIFER LORD
Office Manager
850-862-2555
Organization Subpart ?No
Primary Taxonomy208800000X Urology
Enumeration Date2025-11-07
Last Update Date2025-12-03
Business Address
BASIL FOSSUM MD PA
914B MAR WALT DR
FORT WALTON BEACH, FL 32547-6706
Phone number: 850-862-2555
Mailing Address
BASIL FOSSUM MD PA
914B MAR WALT DR
FORT WALTON BEACH, FL 32547-6706
Phone number: 850-862-2555
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