| Samuel Oliver Starke Irvine Jr, PA-C | |
|
454 Taylor Rd, Montgomery, AL 36117-3563 | |
| (334) 613-9000 | |
| (334) 532-0056 |
| Full Name | Samuel Oliver Starke Irvine Jr |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 454 Taylor Rd, Montgomery, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376590059 | NPI | - | NPPES |
| 009934027 | Medicaid | AL | |
| 009989995 | Medicaid | AL | |
| 009989985 | Medicaid | AL | |
| 051001143 | Other | AL | BLUE CROSS - 860 MONT RD |
| 051001307 | Other | AL | BLUE CROSS - 48 MED PARK |
| 051001308 | Other | AL | BLUE CROSS - 2660 10TH AV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | PA-189 (Alabama) | Secondary |
| 363A00000X | Physician Assistant | PA.189 (Alabama) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel Oliver Starke Irvine Jr, PA-C 454 Taylor Rd, Montgomery, AL 36117-3563 Ph: (334) 613-9000 | Samuel Oliver Starke Irvine Jr, PA-C 454 Taylor Rd, Montgomery, AL 36117-3563 Ph: (334) 613-9000 |
Mr. Norman Edward Hobbs, SURGEON'S ASSISTANT Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2055 E South Blvd Ste 603, Montgomery, AL 36116 Phone: 334-747-8800 Fax: 334-747-8810 | |
Jessica Melvin, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1845 Cherry St, Montgomery, AL 36107 Phone: 334-420-5001 Fax: 334-420-0146 | |
Mr. Jonathan R Ridenour, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 2105 E South Blvd, Montgomery, AL 36116 Phone: 334-288-2100 | |
Richard A Lauderdale Jr., PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 400 Taylor Rd, Montgomery, AL 36117 Phone: 334-272-1050 Fax: 818-587-2493 | |
Darron E Forrest, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 273 Winton M Blount Loop, Montgomery, AL 36117 Phone: 334-280-1500 Fax: 334-280-1611 | |
Colton Pendley, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5345 Atlanta Hwy, Montgomery, AL 36109 Phone: 334-272-5820 | |
Mrs. Emily Anne Grimm, PA- C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2055 E South Blvd Ste 603, Montgomery, AL 36116 Phone: 334-747-8800 Fax: 334-747-8810 |