Fmc Medical Clinic Millport | |
13530 Highway 96 Millport AL 35576-2522 | |
(205) 662-3207 | |
(205) 333-4660 |
Full Name | Fmc Medical Clinic Millport |
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Speciality | Family Medicine |
Location | 13530 Highway 96, Millport, Alabama |
Authorized Official Name and Position | Ryan Campbell (DIRECTOR OF PHYSICIAN SERVICE) |
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 Millport 1820 Rice Mine Rd N Suite 200 Tuscaloosa AL 35406-3281 Ph: (205) 333-4661 | Fmc Medical Clinic Millport 13530 Highway 96 Millport AL 35576-2522 Ph: (205) 662-3207 |
NPI Number | 1063871184 |
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Provider Enumeration Date | 02/17/2016 |
Last Update Date | 06/08/2016 |
Medicare PECOS PAC ID | 8820395809 |
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Medicare Enrollment ID | O20160318002095 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063871184 | NPI | - | NPPES |
183355 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | David Call |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1245233667 PECOS PAC ID: 6103878806 Enrollment ID: I20080512000441 |
Provider Name | Faith Williams Jolly |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306122106 PECOS PAC ID: 7416118559 Enrollment ID: I20120417000112 |
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 | Lindsay Ashby Kemp |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992120158 PECOS PAC ID: 1355648239 Enrollment ID: I20160318002170 |
Provider Name | Hannah L Livingston |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730593625 PECOS PAC ID: 5496034563 Enrollment ID: I20161111001673 |
Provider Name | Crystal A Mccoy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992253090 PECOS PAC ID: 2062795446 Enrollment ID: I20170208003065 |
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 |
Millport Fam Practice Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13530 Highway 96, Millport, AL 35576 Phone: 205-662-5784 Fax: 205-662-5786 | |
Millport Family Practice Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13530 Highway 96, Millport, AL 35576 Phone: 205-662-5784 |