| Canebrake Medical Management | |
|
123 E Capitol St Demopolis AL 36732-2218 | |
| (334) 289-9408 | |
| Not Available |
| Full Name | Canebrake Medical Management |
|---|---|
| Speciality | Family Medicine |
| Location | 123 E Capitol St, Demopolis, Alabama |
| Authorized Official Name and Position | Terre M. Moore (CRNP) |
| Authorized Official Contact | 3342899408 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canebrake Medical Management 123 E Capitol St Demopolis AL 36732-2218 Ph: (334) 289-9408 | Canebrake Medical Management 123 E Capitol St Demopolis AL 36732-2218 Ph: (334) 289-9408 |
| NPI Number | 1821380866 |
|---|---|
| Provider Enumeration Date | 05/10/2011 |
| Last Update Date | 10/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821380866 | NPI | - | NPPES |
| 129958 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 11061 (Alabama) | Primary |
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