Dillon Michael Tate, NURSE PRACTITIONER | |
1728 11th Ave, Haleyville, AL 35565-1506 | |
(205) 465-7822 | |
(260) 399-4004 |
Full Name | Dillon Michael Tate |
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Gender | Male |
Speciality | Family Medicine |
Location | 1728 11th Ave, Haleyville, Alabama |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730874249 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 906197 (Mississippi) | Primary |
Entity Name | Revive Medical Center Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740996636 PECOS PAC ID: 3678947793 Enrollment ID: O20230313001344 |
Mailing Address | Practice Location Address |
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Dillon Michael Tate, NURSE PRACTITIONER 1728 11th Ave, Haleyville, AL 35565-1506 Ph: (205) 485-7822 | Dillon Michael Tate, NURSE PRACTITIONER 1728 11th Ave, Haleyville, AL 35565-1506 Ph: (205) 465-7822 |
Jeffrey Wayne Long, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 42320 Highway 195, Haleyville, AL 35565 Phone: 205-486-8899 Fax: 205-486-8908 | |
Vanessa Ann Ragland, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 42320 Highway 195, Haleyville, AL 35565 Phone: 205-486-8899 Fax: 205-486-8908 | |
Dr. Diana W. Warren, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 42030 Highway 195, Suite C, Haleyville, AL 35565 Phone: 205-485-7337 Fax: 205-485-7393 | |
Holly Slatton Mccaleb, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 904 26th St, Haleyville, AL 35565 Phone: 205-486-5234 Fax: 205-486-5232 | |
Mr. Boyde J Harrison, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 904 26th Street, Haleyville, AL 35565 Phone: 205-486-5234 Fax: 205-486-5232 | |
Elena Ann Roumaya, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 42024 Al-195, Haleyville, AL 35565 Phone: 205-486-5213 |