Full Name | |
---|---|
Speciality | Family Medicine |
Location | 987 Drayton Ave, Elba, Alabama |
Authorized Official Name and Position | Ellen C Briley (CEO) |
Authorized Official Contact | 3348972257 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
987 Drayton Ave Elba AL 36323-1402 Ph: (334) 897-2257 | 987 Drayton Ave Elba AL 36323-1402 Ph: (334) 897-2257 |
NPI Number | 1053571588 |
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Provider Enumeration Date | 06/09/2008 |
Last Update Date | 06/09/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053571588 | NPI | - | NPPES |
558300170 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mizell Memorial Hospital, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 918 Drayton Ave, Elba, AL 36323 Phone: 334-493-5713 | |