Clinic W Llc | |
102 Medical Center Dr Clanton AL 35045-2332 | |
(205) 383-5336 | |
Not Available |
Full Name | Clinic W Llc |
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Speciality | Internal Medicine |
Location | 102 Medical Center Dr, Clanton, Alabama |
Authorized Official Name and Position | David S. Wilson (SOLE MEMBER) |
Authorized Official Contact | 2053835336 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Clinic W Llc 102 Medical Center Dr Clanton AL 35045-2332 Ph: (205) 287-3900 | Clinic W Llc 102 Medical Center Dr Clanton AL 35045-2332 Ph: (205) 383-5336 |
NPI Number | 1578087755 |
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Provider Enumeration Date | 07/31/2017 |
Last Update Date | 01/10/2022 |
Medicare PECOS PAC ID | 5496020877 |
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Medicare Enrollment ID | O20171011001447 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578087755 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 26067 (Alabama) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Provider Name | David S Wilson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1245271444 PECOS PAC ID: 0345277067 Enrollment ID: I20050725000199 |
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