South Alabama Medical Clinic, Llc | |
10075 Grand Bay Wilmer Rd S Grand Bay AL 36541-5003 | |
(251) 865-1852 | |
(251) 865-1854 |
Full Name | South Alabama Medical Clinic, Llc |
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Speciality | Clinic/Center |
Location | 10075 Grand Bay Wilmer Rd S, Grand Bay, Alabama |
Authorized Official Name and Position | Bridgot Peters (DIRECTOR) |
Authorized Official Contact | 2514457618 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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South Alabama Medical Clinic, Llc 10075 Grand Bay Wilmer Rd S Grand Bay AL 36541-5003 Ph: (251) 865-1852 | South Alabama Medical Clinic, Llc 10075 Grand Bay Wilmer Rd S Grand Bay AL 36541-5003 Ph: (251) 865-1852 |
NPI Number | 1811288038 |
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Provider Enumeration Date | 04/21/2011 |
Last Update Date | 08/29/2024 |
Certification Date | 08/29/2024 |
Medicare PECOS PAC ID | 0345428363 |
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Medicare Enrollment ID | O20110622000356 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811288038 | NPI | - | NPPES |
140171 | Other | AL | RURAL HEALTH MEDICAID |
129323 | Medicaid | AL |
Provider Name | Robert E Vickers |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1982611158 PECOS PAC ID: 8022919448 Enrollment ID: I20050715000546 |
Provider Name | Kristina E Ray |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1598831422 PECOS PAC ID: 3779677596 Enrollment ID: I20070924000360 |
Provider Name | Lloyd S Stokes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457546319 PECOS PAC ID: 6204915556 Enrollment ID: I20080512000385 |
Provider Name | Taniya L Smith |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1679669550 PECOS PAC ID: 0648330753 Enrollment ID: I20081119000609 |
Provider Name | Gregory R Myrick |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972786960 PECOS PAC ID: 9335335942 Enrollment ID: I20101122000963 |
Provider Name | Deanna L Thomas |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669719928 PECOS PAC ID: 6204081391 Enrollment ID: I20130220000503 |
Provider Name | Chassidy N Hammond |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932407004 PECOS PAC ID: 0042520900 Enrollment ID: I20151104001586 |
Provider Name | Penny X Dupre |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1417117664 PECOS PAC ID: 2264673219 Enrollment ID: I20151112000722 |
Provider Name | Deanna Seaman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215447750 PECOS PAC ID: 5991050478 Enrollment ID: I20180625002630 |
Provider Name | Andrew Rockwell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447887567 PECOS PAC ID: 1355771932 Enrollment ID: I20200422001950 |
Provider Name | Justin Stokes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932674975 PECOS PAC ID: 7517386691 Enrollment ID: I20200923003183 |
Provider Name | Haley Hespen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245856400 PECOS PAC ID: 6507286358 Enrollment ID: I20201015001845 |
Provider Name | Parath Knight |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558938282 PECOS PAC ID: 1557765328 Enrollment ID: I20210802003053 |
Provider Name | Tiffany Franklin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568045060 PECOS PAC ID: 4688079379 Enrollment ID: I20210818001931 |
Provider Name | Melissa Sprinkle |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396360103 PECOS PAC ID: 5597180521 Enrollment ID: I20240112001163 |
Bhg Medical Services - Grand Bay Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12271 Interchange Drive, Grand Bay, AL 36541 Phone: 251-865-0123 Fax: 251-865-0247 | |
South Alabama Medical Clinic Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10075 Grand Bay Wilmer Rd S, Grand Bay, AL 36541 Phone: 251-865-1852 Fax: 251-865-1854 | |
Ttc, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 12271 Interchange Drive, Grand Bay, AL 36541 Phone: 251-865-0123 Fax: 251-865-0247 |