| Organization Name: | MAR-WALT DRIVE EMERGENCY PHYSICIANS, LLC |
| NPI Number: | 1043652498 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH H. GATEWOOD (PRESIDENT) |
| Mailing Address: | 1000 Mar Walt Dr Fort Walton Beach |
| State: | FL US |
| Postal Code: | 325476708 |
| Phone Number: | 8508637610 |
| Fax Number: | 8003053233 |
| NPI Enumeration Date: | 07/26/2013 |
| NPI Last Update Date: | 07/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207PP0204X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Emergency Medicine |
| Taxonomy Specialization: | Pediatric Emergency Medicine |
| Taxonomy Definition: | Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. |