Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Magnolia Medical Clinic PA

Organization Family Medicine Physician · NPI 1053110619

Magnolia Medical Clinic PA is a Family Medicine Physician in Destin, Florida. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4012 Commons Dr W
Destin, FL 32541-8422
Phone: (850) 243-7681
Fax: (850) 243-0471
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1053110619
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Crystal Weatherington — Practice Administrator · (850) 243-0520
NPI enumeratedMarch 7, 2025
Last updated in NPPESMarch 7, 2025
Certification dateMarch 7, 2025
Mailing address319 Green Acres Rd Ste 101, Fort Walton Beach, FL 32547-1170

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