| Jack M Englert Md Pc | |
|
101 Bob Wallace Ave Sw Suite D Huntsville AL 35801-3847 | |
| (256) 517-1507 | |
| (256) 517-1508 |
| Full Name | Jack M Englert Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 101 Bob Wallace Ave Sw, Huntsville, Alabama |
| Authorized Official Name and Position | Jack Manuel Englert (PRESIDENT) |
| Authorized Official Contact | 2565171507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack M Englert Md Pc 101 Bob Wallace Ave Sw Suite D Huntsville AL 35801-3847 Ph: (256) 517-1507 | Jack M Englert Md Pc 101 Bob Wallace Ave Sw Suite D Huntsville AL 35801-3847 Ph: (256) 517-1507 |
| NPI Number | 1942531959 |
|---|---|
| Provider Enumeration Date | 01/15/2010 |
| Last Update Date | 01/23/2010 |
| Medicare PECOS PAC ID | 0840332532 |
|---|---|
| Medicare Enrollment ID | O20100119000223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942531959 | NPI | - | NPPES |
| E87616 | Other | AL | UPIN |
| 051503250 | Other | AL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | AL15840 (Alabama) | Primary |
| Provider Name | Jack Englert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558324186 PECOS PAC ID: 9234280918 Enrollment ID: I20100119000208 |
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