| Cheryl C. Bazzle Md, Pc | |
|
333 Whitesport Dr Sw Suite 103 Huntsville AL 35801-6454 | |
| (256) 880-9345 | |
| (256) 880-3961 |
| Full Name | Cheryl C. Bazzle Md, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 333 Whitesport Dr Sw, Huntsville, Alabama |
| Authorized Official Name and Position | Cheryl C Bazzle (MD/OWNER) |
| Authorized Official Contact | 2568809345 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cheryl C. Bazzle Md, Pc 333 Whitesport Dr Sw Suite 103 Huntsville AL 35801-6454 Ph: (256) 880-9345 | Cheryl C. Bazzle Md, Pc 333 Whitesport Dr Sw Suite 103 Huntsville AL 35801-6454 Ph: (256) 880-9345 |
| NPI Number | 1619150034 |
|---|---|
| Provider Enumeration Date | 12/07/2007 |
| Last Update Date | 02/10/2020 |
| Medicare PECOS PAC ID | 5395638050 |
|---|---|
| Medicare Enrollment ID | O20040205000912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619150034 | NPI | - | NPPES |
| J621 | Other | AL | MEDICARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Cheryl Carden Bazzle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942419643 PECOS PAC ID: 9739072406 Enrollment ID: I20040210000476 |
| Provider Name | Jill Obrien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144437856 PECOS PAC ID: 5597068098 Enrollment ID: I20160115001379 |
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