Dr Luz Jovita Crystal, MD | |
2202 Jordan Road Sw, Suite 500, Fort Payne, AL 35968-3688 | |
(256) 844-2825 | |
(256) 844-2834 |
Full Name | Dr Luz Jovita Crystal |
---|---|
Gender | Female |
Speciality | Internal Medicine |
Location | 2202 Jordan Road 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 |
---|---|---|---|
1972544153 | NPI | - | NPPES |
051558061 | Medicaid | AL | |
510-03925 | Other | AL | BCBS |
541385610 | Medicaid | AL | |
051557585 | Medicaid | AL | |
510-03714 | Other | AL | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 00018535 (Alabama) | Primary |
Entity Name | Fort Payne Clinic Corp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396764395 PECOS PAC ID: 5698779304 Enrollment ID: O20060912000391 |
Entity Name | Fort Payne Hbp Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740748821 PECOS PAC ID: 7618201302 Enrollment ID: O20190701000565 |
Entity Name | Em Transform, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285417154 PECOS PAC ID: 6507216454 Enrollment ID: O20231219002105 |
Mailing Address | Practice Location Address |
---|---|
Dr Luz Jovita Crystal, MD 2202 Jordan Road Sw, Suite 500, Fort Payne, AL 35968-3688 Ph: (256) 844-2825 | Dr Luz Jovita Crystal, MD 2202 Jordan Road Sw, Suite 500, Fort Payne, AL 35968-3688 Ph: (256) 844-2825 |
Dr. Carmelo Cabalu Mendiola, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2202 Jordan Road Sw, Suite 500, Fort Payne, AL 35968 Phone: 256-844-2825 Fax: 256-844-2834 | |
Dr. Daniel Martin Mince, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 415 Medical Center Dr Sw, Fort Payne, AL 35968 Phone: 256-997-2820 Fax: 256-997-2890 | |
Dr. Thomas Dalsgaard Nielsen, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 415 Medical Center Dr Sw, Fort Payne, AL 35968 Phone: 256-997-2820 | |
Dr. John Bennett Weaver Ii, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 1906 Glenn Blvd Sw, Fort Payne, AL 35968 Phone: 256-845-7555 Fax: 256-845-4499 | |
Dr. Wael Al-halaseh, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 306 Medical Center Dr Sw, Fort Payne, AL 35968 Phone: 256-845-9255 Fax: 256-845-9349 | |
Dr. Frederico Yambao Fernandez, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2804 Greenhill Blvd Nw, Suite 101, Fort Payne, AL 35968 Phone: 256-845-0023 Fax: 256-845-0238 |