Dodge City Medical Clinic, Inc. | |
561 Al Highway 69 S Suite B Hanceville AL 35077-3403 | |
(256) 287-2345 | |
Not Available |
Full Name | Dodge City Medical Clinic, Inc. |
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Speciality | Clinic/Center |
Location | 561 Al Highway 69 S, Hanceville, Alabama |
Authorized Official Name and Position | Richard Anthony Bucco (PRESIDENT) |
Authorized Official Contact | 2562872345 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dodge City Medical Clinic, Inc. Po Box 1208 Cullman AL 35056-1208 Ph: (256) 287-2345 | Dodge City Medical Clinic, Inc. 561 Al Highway 69 S Suite B Hanceville AL 35077-3403 Ph: (256) 287-2345 |
NPI Number | 1407976624 |
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Provider Enumeration Date | 03/30/2007 |
Last Update Date | 12/15/2008 |
Medicare PECOS PAC ID | 0345344164 |
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Medicare Enrollment ID | O20070403000382 |
Identifier | Type | State | Issuer |
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1407976624 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | MD27216 (Alabama) | Primary |
Provider Name | Richard A Bucco |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1518945724 PECOS PAC ID: 7315902210 Enrollment ID: I20060301000353 |
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