| Clinic Of Gadsden, Pc | |
|
1401 Rainbow Dr Ste B Gadsden AL 35901-5319 | |
| (256) 646-6358 | |
| Not Available |
| Full Name | Clinic Of Gadsden, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1401 Rainbow Dr Ste B, Gadsden, Alabama |
| Authorized Official Name and Position | Jonathan Hubbard Fuller (CEO) |
| Authorized Official Contact | 2566466358 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinic Of Gadsden, Pc Po Box 860 Gadsden AL 35902-0860 Ph: (256) 646-6358 | Clinic Of Gadsden, Pc 1401 Rainbow Dr Ste B Gadsden AL 35901-5319 Ph: (256) 646-6358 |
| NPI Number | 1427566181 |
|---|---|
| Provider Enumeration Date | 01/16/2018 |
| Last Update Date | 01/29/2018 |
| Medicare PECOS PAC ID | 3375899750 |
|---|---|
| Medicare Enrollment ID | O20180628000614 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427566181 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DO.1762 (Alabama) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Jonathan H Fuller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013315001 PECOS PAC ID: 1658643432 Enrollment ID: I20180628001046 |
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