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

Magnolia Medical Clinic PA

Organization Family Medicine Physician · NPI 1639281652

Magnolia Medical Clinic PA is a Family Medicine Physician in Fort Walton Beach, Florida. Works from 3 locations. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2
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

319 Green Acres Rd Ste 101
Fort Walton Beach, FL 32547
Phone: (850) 243-7681
Fax: (850) 243-0471
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 4012 Commons Dr W, Destin, FL 32541-8422 — (850) 243-7681
  • 131 Magnolia Ave Se, Fort Walton Beach, FL 32548-7266 — (850) 243-7681

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1639281652
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Crystal Weatherington — Practice Administrator · (850) 243-0520
NPI enumeratedAugust 31, 2006
Last updated in NPPESMarch 10, 2025
Certification dateMarch 10, 2025
Mailing address319 Green Acres Rd Ste 101, Fort Walton Beach, FL 32547-1170

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