Childersburg Primary Care | |
34011 Highway 280 East Childersburg AL 35044 | |
(256) 378-3313 | |
(256) 378-3315 |
Full Name | Childersburg Primary Care |
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Speciality | Family Medicine |
Location | 34011 Highway 280 East, Childersburg, Alabama |
Authorized Official Name and Position | Mike Bice (ADMINISTRATOR) |
Authorized Official Contact | 2563783313 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Childersburg Primary Care 34011 Highway 280 East Childersburg AL 35044 Ph: (256) 378-3313 | Childersburg Primary Care 34011 Highway 280 East Childersburg AL 35044 Ph: (256) 378-3313 |
NPI Number | 1952484081 |
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Provider Enumeration Date | 10/23/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 4981504172 |
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Medicare Enrollment ID | O20040127001203 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952484081 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Gordon T Connor |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1801804703 PECOS PAC ID: 7113816570 Enrollment ID: I20040312001170 |
Provider Name | Jarod E Speer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609947993 PECOS PAC ID: 6002911781 Enrollment ID: I20070425000435 |
Provider Name | Molly Andrews Ellis |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1811430473 PECOS PAC ID: 8628304441 Enrollment ID: I20190731001351 |
Provider Name | Jerica Lashay Gibson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467072926 PECOS PAC ID: 5496178147 Enrollment ID: I20230810000266 |
Nix Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 33733 Us Highway 280, Childersburg, AL 35044 Phone: 256-378-3301 | |
Diabetic And Wound Care Management Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 34011 Us Highway 280, Childersburg, AL 35044 Phone: 256-378-3313 Fax: 256-378-3315 |