| Family Medicine Of Sardis Pc | |
|
1180 Sardis Dr Sardis City AL 35956-2139 | |
| (256) 593-9999 | |
| (256) 593-9141 |
| Full Name | Family Medicine Of Sardis Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1180 Sardis Dr, Sardis City, Alabama |
| Authorized Official Name and Position | Evan Michael Johnson (PRESIDENT, OWNER) |
| Authorized Official Contact | 2565939999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Of Sardis Pc Po Box 1049 Boaz AL 35957-2201 Ph: (256) 593-9999 | Family Medicine Of Sardis Pc 1180 Sardis Dr Sardis City AL 35956-2139 Ph: (256) 593-9999 |
| NPI Number | 1245398304 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 12/11/2007 |
| Medicare PECOS PAC ID | 5193709251 |
|---|---|
| Medicare Enrollment ID | O20040616000233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245398304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DO779 (Alabama) | Primary |
| Provider Name | Evan M Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659399772 PECOS PAC ID: 5597749655 Enrollment ID: I20040616000317 |
| Provider Name | April B Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548621220 PECOS PAC ID: 0244539716 Enrollment ID: I20160504002420 |
| Provider Name | Courtney Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770040941 PECOS PAC ID: 1557697653 Enrollment ID: I20190726002635 |