Gmuc Of Citronelle Llc | |
19355 N 3rd St Suite 104 Citronelle AL 36522-2049 | |
(251) 633-0123 | |
(251) 445-3722 |
Full Name | Gmuc Of Citronelle Llc |
---|---|
Speciality | Family Medicine |
Location | 19355 N 3rd St, Citronelle, Alabama |
Authorized Official Name and Position | Darren K Waters (MEDICAL DIRECTOR) |
Authorized Official Contact | 2516330123 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gmuc Of Citronelle Llc 7943 Moffett Rd Semmes AL 36575-5409 Ph: (251) 633-0123 | Gmuc Of Citronelle Llc 19355 N 3rd St Suite 104 Citronelle AL 36522-2049 Ph: (251) 633-0123 |
NPI Number | 1164794343 |
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Provider Enumeration Date | 02/02/2012 |
Last Update Date | 08/02/2023 |
Medicare PECOS PAC ID | 8426210014 |
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Medicare Enrollment ID | O20120426000475 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164794343 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
Provider Name | Dorothy Shannon Waters-hwang |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1457333650 PECOS PAC ID: 3072576545 Enrollment ID: I20041105000302 |
Provider Name | Stacy A Upshaw |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710998018 PECOS PAC ID: 4587637475 Enrollment ID: I20050223000467 |
Provider Name | Christopher J Frailie |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1487710042 PECOS PAC ID: 5092750471 Enrollment ID: I20050627000266 |
Provider Name | Dariusz A Skladaniec |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1972552750 PECOS PAC ID: 1557360013 Enrollment ID: I20061211000197 |
Provider Name | Darren Waters |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1568419661 PECOS PAC ID: 9830293406 Enrollment ID: I20081017000005 |
Provider Name | Parag A Mahatekar |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1962458984 PECOS PAC ID: 3577516715 Enrollment ID: I20081020000607 |
Provider Name | Kristin Tomlinson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528291861 PECOS PAC ID: 9638216658 Enrollment ID: I20091023000606 |
Provider Name | Lynne Mcdonnell |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1538172879 PECOS PAC ID: 0749454684 Enrollment ID: I20111110000808 |
Provider Name | Amanda J Smitherman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497022776 PECOS PAC ID: 2062676174 Enrollment ID: I20120620000630 |
Provider Name | Patrick C Mcguire |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1801809124 PECOS PAC ID: 2567467293 Enrollment ID: I20130926000309 |
Provider Name | Ashley D Myers |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1528352028 PECOS PAC ID: 9335389485 Enrollment ID: I20141104000686 |
Provider Name | Rebecca Alsip Iskandar |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1235367699 PECOS PAC ID: 1658544119 Enrollment ID: I20160216000166 |
Provider Name | Rollie Demetrius Steele |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972616779 PECOS PAC ID: 3971531955 Enrollment ID: I20170206000811 |
Provider Name | Jennifer Kathleen Griffin |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609002500 PECOS PAC ID: 4385808476 Enrollment ID: I20170724003941 |
Provider Name | Theresa Yarbrough |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1730573627 PECOS PAC ID: 7911203526 Enrollment ID: I20171006001845 |
Provider Name | Christopher Stagner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891211496 PECOS PAC ID: 4385908755 Enrollment ID: I20180510002663 |
Provider Name | Timothy Hughes |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1740223742 PECOS PAC ID: 0143240135 Enrollment ID: I20191118001053 |
Provider Name | Angela Bevill |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1801284633 PECOS PAC ID: 3577824507 Enrollment ID: I20200221000242 |
Provider Name | Jamie Kathryn Turner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417504325 PECOS PAC ID: 0345652103 Enrollment ID: I20201219000004 |
Provider Name | Angelia Danielle Anderson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205421435 PECOS PAC ID: 3870901937 Enrollment ID: I20210409001692 |
Provider Name | Matthew Brent Pickich |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1861020208 PECOS PAC ID: 4284051996 Enrollment ID: I20220531000932 |
Provider Name | Taylor Rae Cook |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1144858838 PECOS PAC ID: 0547687295 Enrollment ID: I20220608000812 |
Provider Name | Zachary Kyle Clark |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1063049054 PECOS PAC ID: 3870910342 Enrollment ID: I20220805003143 |
Provider Name | Breanna Shiree Heard Pinho |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1265068290 PECOS PAC ID: 6002235066 Enrollment ID: I20220902002916 |
Provider Name | John Alvin Green |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1942838875 PECOS PAC ID: 0345668380 Enrollment ID: I20221019000677 |
Provider Name | Sarah Diana Dabbas |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1346877354 PECOS PAC ID: 9032537899 Enrollment ID: I20221130001920 |
Provider Name | Frederick Joseph Rossi |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1003444373 PECOS PAC ID: 6800213455 Enrollment ID: I20230110000181 |
Provider Name | Kendall Bruns Whigham |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871246140 PECOS PAC ID: 4981076353 Enrollment ID: I20230213000170 |
Provider Name | John Belk |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1790199982 PECOS PAC ID: 1759682321 Enrollment ID: I20230410001409 |
Provider Name | Luke M Mueller |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1518594621 PECOS PAC ID: 2163841362 Enrollment ID: I20230424000169 |
Provider Name | Dillon Noland |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1407315401 PECOS PAC ID: 9032444161 Enrollment ID: I20230425002343 |
Provider Name | Hunter Chance Dickson |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1700463999 PECOS PAC ID: 9032513304 Enrollment ID: I20230726001324 |
Provider Name | Justine Mckee |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1174167092 PECOS PAC ID: 7214331578 Enrollment ID: I20230928002765 |
Provider Name | Heather K Bateman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851524532 PECOS PAC ID: 0446326045 Enrollment ID: I20231005000340 |
Provider Name | Seema Mir |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1659936490 PECOS PAC ID: 7618375791 Enrollment ID: I20231017000836 |
Provider Name | Alana Brooks Edgar |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437927415 PECOS PAC ID: 5092166876 Enrollment ID: I20240105000848 |
Citronelle Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 19250 N Mobile St, Citronelle, AL 36522 Phone: 251-866-9129 Fax: 251-866-9121 | |
Citronelle Dental Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19260 N Mobile St, Citronelle, AL 36522 Phone: 251-866-5585 Fax: 251-866-9121 | |
Providence Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19140 S 3rd St, Citronelle, AL 36522 Phone: 251-866-0086 Fax: 251-866-0089 | |
Providence Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19140 S 3rd St, Citronelle, AL 36522 Phone: 251-866-0086 Fax: 251-866-0089 |