| Fennell Medical Services, Llc | |
|
701 Princeton Ave Sw Birmingham AL 35211-1303 | |
| (205) 785-4811 | |
| (205) 785-4810 |
| Full Name | Fennell Medical Services, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 701 Princeton Ave Sw, Birmingham, Alabama |
| Authorized Official Name and Position | Ricky Fennell (PRESIDENT) |
| Authorized Official Contact | 2057854811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fennell Medical Services, Llc Po Box 70 Fairfield AL 35064-0070 Ph: (205) 785-4811 | Fennell Medical Services, Llc 701 Princeton Ave Sw Birmingham AL 35211-1303 Ph: (205) 785-4811 |
| NPI Number | 1083730519 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9739134487 |
|---|---|
| Medicare Enrollment ID | O20050316000348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083730519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 21526 (Alabama) | Primary |
| Provider Name | Ricky L Fennell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689618357 PECOS PAC ID: 6608862040 Enrollment ID: I20040421001904 |
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