Fmc Medical Clinic - Berry Llc | |
32 School Ave Berry AL 35546-2246 | |
(205) 689-0909 | |
Not Available |
Full Name | Fmc Medical Clinic - Berry Llc |
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Speciality | Family Medicine |
Location | 32 School Ave, Berry, Alabama |
Authorized Official Name and Position | Daniel Clay Conville (CORP DIRECTOR, PHYSICIAN SERVICES) |
Authorized Official Contact | 2057596165 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fmc Medical Clinic - Berry Llc 3901 Greensboro Ave Ste A Tuscaloosa AL 35405-3771 Ph: (205) 759-6165 | Fmc Medical Clinic - Berry Llc 32 School Ave Berry AL 35546-2246 Ph: (205) 689-0909 |
NPI Number | 1588376800 |
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Provider Enumeration Date | 12/19/2022 |
Last Update Date | 12/19/2022 |
Medicare PECOS PAC ID | 5890167696 |
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Medicare Enrollment ID | O20230203001180 |
Identifier | Type | State | Issuer |
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1588376800 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Cortney L Brown |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154795177 PECOS PAC ID: 7416251764 Enrollment ID: I20160205001375 |
Provider Name | Dakota Acton-jones |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1790167864 PECOS PAC ID: 1153638192 Enrollment ID: I20181017002326 |
Provider Name | Kristin Moudry |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720568363 PECOS PAC ID: 6002150711 Enrollment ID: I20181206003578 |