Provider Demographics
NPI:1548233232
Name:LARRY J SAULS, M.D. P.A.
Entity type:Organization
Organization Name:LARRY J SAULS, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAULS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-433-7840
Mailing Address - Street 1:PO BOX 9416
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-9416
Mailing Address - Country:US
Mailing Address - Phone:850-433-7840
Mailing Address - Fax:
Practice Address - Street 1:2606 YATES AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-4982
Practice Address - Country:US
Practice Address - Phone:850-433-7840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0017405207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL17299OtherFLORIDA BLUE SHIELD
FL59020229OtherALABAMA BLUE SHIELD ID #
FL17299Medicare ID - Type UnspecifiedMEDICARE ID #
FLD53220Medicare UPIN