Austin Lively, MD | |
1359 Old Water Works Rd Sw, Fort Payne, AL 35968-3347 | |
(256) 997-5900 | |
(888) 977-1691 |
Full Name | Austin Lively |
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Gender | Male |
Speciality | Pediatrics |
Location | 1359 Old Water Works Rd Sw, Fort Payne, Alabama |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871976639 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 080335 (Georgia) | Secondary |
208000000X | Pediatrics | 7481 (Georgia) | Secondary |
208000000X | Pediatrics | 37983 (Alabama) | Primary |
Entity Name | Au Medical Associates Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841230620 PECOS PAC ID: 9931013513 Enrollment ID: O20040107000188 |
Mailing Address | Practice Location Address |
---|---|
Austin Lively, MD 1359 Old Water Works Rd Sw, Fort Payne, AL 35968-3347 Ph: (256) 997-5900 | Austin Lively, MD 1359 Old Water Works Rd Sw, Fort Payne, AL 35968-3347 Ph: (256) 997-5900 |
Robert Mike Story, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 550 Medical Center Dr Sw, Fort Payne, AL 35968 Phone: 256-845-3121 Fax: 256-845-9546 | |
Dr. Frine T Roca, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 205 Grand Ave Nw, Ste B, Fort Payne, AL 35967 Phone: 256-979-1515 Fax: 256-979-1517 | |
Angela E Chaney, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 550 Medical Center Dr Sw, Fort Payne, AL 35968 Phone: 256-845-3121 Fax: 256-845-9546 | |
Monique M. Sherrill, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1202 Gault Ave N, Fort Payne, AL 35967 Phone: 256-997-3434 | |
David Allen Atchley, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 550 Medical Center Dr Sw, Fort Payne, AL 35968 Phone: 256-845-3121 Fax: 256-845-9759 |