Extended Arm Physicians Inc | |
1725 W 4th St Montgomery AL 36106 | |
(334) 262-2071 | |
(334) 269-9777 |
Full Name | Extended Arm Physicians Inc |
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Speciality | Internal Medicine |
Location | 1725 W 4th St, Montgomery, Alabama |
Authorized Official Name and Position | Leon Nolan Davis (PRESIDENT OWNER) |
Authorized Official Contact | 3342622071 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Extended Arm Physicians Inc Po Box 230577 Montgomery AL 36123-0577 Ph: (334) 262-2071 | Extended Arm Physicians Inc 1725 W 4th St Montgomery AL 36106 Ph: (334) 262-2071 |
NPI Number | 1326009366 |
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Provider Enumeration Date | 03/29/2006 |
Last Update Date | 04/16/2020 |
Medicare PECOS PAC ID | 5193627636 |
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Medicare Enrollment ID | O20040123000959 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326009366 | NPI | - | NPPES |
000022924 | Medicaid | AL | |
051022924 | Other | AL | BCBS OF AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 00016726 (Alabama) | Primary |
Provider Name | Leon Nolan Davis |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1265493134 PECOS PAC ID: 6901708452 Enrollment ID: I20040710000280 |
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