Individual provider · Type 1 NPI

Gary William Mousseau, PA-C

Medical Physician Assistant · Fort Walton Beach, FL

NPI number 1861593956 Active

Practice location

1005 Mar Walt Drive
Fort Walton Beach, FL 32547-6707

Call (850) 863-6600 Map

Fax (850) 862-0977

Mailing address

1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA9112347 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1861593956

Gary William Mousseau, PA-C's National Provider Identifier is 1861593956, issued on Sep 25, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Fort Walton Beach, FL. The record was last updated on Jul 30, 2019.