DR. RANDALL LOUIS MCKISSACK


Address: 999 Mar Walt Dr, Fort Walton Beach, FL 32547-6758
Phone: 8508638269

DR. RANDALL LOUIS MCKISSACK (NPI# 1487639621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487639621
Entity Type Individual
Full Name DR. RANDALL LOUIS MCKISSACK
Credential M.D.
Practice Address 999 Mar Walt Dr
Fort Walton Beach
FL 32547-6758
Mailing Address 801 E. 6th Street
Suite 602
Panama City
FL 32401-3663
Practice Telephone 8508638269
Practice Fax Number 8508627965
Mailing Telephone 8509136960
Mailing Fax Number 8509147065
Enumeration Date 2005-12-09
Last Update Date 2019-06-12
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208600000X Surgery ME96715 FL Allopathic & Osteopathic Physicians

Office Location

Street Address 999 MAR WALT DR
City FORT WALTON BEACH
State FL
Zip Code 32547-6758

Providers in the same location

NPI Name Taxonomy Address Enumeration
1619979937 Frank C Zondlo Specialist 999 Mar Walt Dr, Fort Walton Beach, FL 32547-6758 2005-06-01
1033473772 Shawn Gerard Hughes Anesthesiology 999 Mar Walt Dr, Fort Walton Beach, FL 32547 2012-06-27
1720009046 Physiatry Pain Management, P.a Specialist 999 Mar Walt Dr, Fort Walton Beach, FL 32547-6758 2006-07-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255944955 Theresa Ann Morvay Behavior Technician 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 2020-08-24
1588295422 Emily Ann Glossop Nurse Practitioner 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 2020-01-29
1225669443 Elizabeth Rogers Nagengast Physician Assistant 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 2020-01-27
1497254791 Carmen Alston Nurse Practitioner 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 2018-02-02
1871004960 Center for Neuropsychological Services Cns Clinical Neuropsychologist 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 2017-10-17
1194235648 Robin Wray Speech-Language Pathologist 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 2017-10-10
1285007989 Dynamic Pain & Wellness Pllc Pain Medicine 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 2015-11-04
1013392810 Terry Abbott Social Worker 648 Overbrook Dr, Fort Walton Beach, FL 32547 2015-07-22
1083024673 Emily Lohr Physical Therapy Assistant 2000 Principle Ln, Ft. Walton Beach, FL 32547 2014-05-05
1831526102 Laurie Ann Schweppe Nurse Practitioner 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 2013-10-02
Find all providers in zip 32547

Taxonomy Information

Taxonomy Code 208600000X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery

Taxonomy Definition

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 increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1467437616 David W Burkland Surgery 999 Mar Walt Drive, White-wilson East Building, Fort Walton Beach, FL 32547-6707 2005-12-09
1609872688 John Robert Brent Surgery 1032 Mar Walt Dr, Ste 220, Fort Walton Beach, FL 32547-6645 2005-06-23
1518338565 Advanced Vascular Care Inc Surgery 2010 Lewis Turner Blvd, Fort Walton Beach, FL 32547-1352 2015-10-16
1659770311 Tara Harden M.d., P.a. Surgery 1775 Lewis Turner Blvd, Suite 101, Fort Walton Beach, FL 32547-1267 2014-08-19
1063852192 Emilio Claudio Calabrese Surgery 2010 Lewis Turner Blvd, Fort Walton Beach, FL 32547 2013-07-03
1174677124 Patrick Thomas Mcgraw Surgery 1703 Lewis Turner Blvd, Fort Walton Beach, FL 32547-1221 2007-01-23
1902839798 Mauri G Lunderman, M.d., P.a. Surgery 1775 Lewis Turner Blvd, Suite 102, Fort Walton Beach, FL 32547-1221 2006-07-08
1023083177 John Christofer Dali Surgery 999 Mar Walt Drive, White-wilson East Building, Fort Walton Beach, FL 32547-6707 2006-02-22
1073598983 Robert Lane Rogers Surgery 999 Mar Walt Drive, White-wilson East Building, Fort Walton Beach, FL 32547 2005-12-13
1346222122 Michael William Restey Surgery 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 2005-11-16
Find all providers in FORT WALTON BEACH

Competitor

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City FORT WALTON BEACH
Zip Code 32547

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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