East Alabama Family Practice, P.c. | |
2214 Gateway Dr Suite C Opelika AL 36801-1500 | |
(334) 741-0075 | |
(334) 741-4075 |
Full Name | East Alabama Family Practice, P.c. |
---|---|
Speciality | Family Medicine |
Location | 2214 Gateway Dr, Opelika, Alabama |
Authorized Official Name and Position | Keith Lyle Fuller (PRESIDENT) |
Authorized Official Contact | 3347410075 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
East Alabama Family Practice, P.c. 2214 Gateway Dr Suite C Opelika AL 36801-1500 Ph: (334) 741-0075 | East Alabama Family Practice, P.c. 2214 Gateway Dr Suite C Opelika AL 36801-1500 Ph: (334) 741-0075 |
NPI Number | 1386719193 |
---|---|
Provider Enumeration Date | 11/21/2006 |
Last Update Date | 12/22/2022 |
Medicare PECOS PAC ID | 3173584976 |
---|---|
Medicare Enrollment ID | O20041025000925 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386719193 | NPI | - | NPPES |
529602340 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | DO-350 (Alabama) | Primary |
Provider Name | Keith L Fuller |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1730125527 PECOS PAC ID: 9335100148 Enrollment ID: I20051128000429 |
Provider Name | Dorothea Harris |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578923520 PECOS PAC ID: 7810296084 Enrollment ID: I20160422001394 |
Provider Name | Elizabeth Kelley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700261591 PECOS PAC ID: 0547552291 Enrollment ID: I20160718000003 |
Provider Name | Laura Walton Bell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629519558 PECOS PAC ID: 9931532199 Enrollment ID: I20191203000969 |
East Alabama Medical Development Associates, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2000 Pepperell Pkwy, Opelika, AL 36801 Phone: 334-705-1822 Fax: 334-705-1407 | |
Internal Medicine Associates P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 121 N 20th St, #6, Opelika, AL 36801 Phone: 334-749-3385 Fax: 334-745-7672 | |
Aspire Integrative Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2202 Gateway Dr Ste D, Opelika, AL 36801 Phone: 334-203-1723 | |