| Infectious Disease Specialists Of Mtg Pc | |
|
1801 Pine St Montgomery AL 36106-0165 | |
| (334) 293-8138 | |
| (334) 293-8134 |
| Full Name | Infectious Disease Specialists Of Mtg Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1801 Pine St, Montgomery, Alabama |
| Authorized Official Name and Position | Glenn D Bedsole (PRESIDENT - OWNER) |
| Authorized Official Contact | 3343248893 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Disease Specialists Of Mtg Pc Po Box 242848 Montgomery AL 36124-2848 Ph: (334) 270-9914 | Infectious Disease Specialists Of Mtg Pc 1801 Pine St Montgomery AL 36106-0165 Ph: (334) 293-8138 |
| NPI Number | 1255481230 |
|---|---|
| Provider Enumeration Date | 01/11/2007 |
| Last Update Date | 07/20/2015 |
| Medicare PECOS PAC ID | 0446280606 |
|---|---|
| Medicare Enrollment ID | O20050817000340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255481230 | NPI | - | NPPES |
| 528801490 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Glenn D Bedsole |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1699755975 PECOS PAC ID: 1254361413 Enrollment ID: I20101020000220 |
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