Individual provider · Type 1 NPI
Tara Rexanne Ennis, MD
Surgery Physician · Fort Walton Beach, FL
Practice location
1042 Mar Walt Dr
Fort Walton Beach, FL 32547-6645
Fax (850) 863-0417
Mailing address
1775 Lewis Turner Blvd, Suite 101
Fort Walton Beach, FL 32547-1267
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist | 174400000X | 28214 (AL) |
| Surgery Physician Primary | 208600000X | ME121048 (FL) |
Surgery Physician: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasin…
2 other providers at this address
Other surgery physician providers in Fort Walton Beach
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- Mauri G. Lunderman, MDSurgery Physician Fort Walton Beach, FL NPI 1033103825
- Emilio Claudio Calabrese, MDSurgery Physician Fort Walton Beach, FL NPI 1063852192
- Robert Lane Rogers, MDSurgery Physician Fort Walton Beach, FL NPI 1073598983
- Patrick Thomas McGraw, MDSurgery Physician Fort Walton Beach, FL NPI 1174677124
- Sandra Lee Hanson, MDSurgery Physician Fort Walton Beach, FL NPI 1235105529
- Michael William Restey, MDSurgery Physician Fort Walton Beach, FL NPI 1346222122
- David W. Burkland, MDSurgery Physician Fort Walton Beach, FL NPI 1467437616
About NPI 1700961141
Tara Rexanne Ennis, MD's National Provider Identifier is 1700961141, issued on Oct 26, 2006. The primary taxonomy on file is Surgery Physician (208600000X), and the practice location is in Fort Walton Beach, FL. The record was last updated on Jul 7, 2021.