| Jasper Family Practice Center Pc | |
|
2201 N Airport Rd Jasper AL 35504-7058 | |
| (205) 221-9351 | |
| (205) 221-4353 |
| Full Name | Jasper Family Practice Center Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2201 N Airport Rd, Jasper, Alabama |
| Authorized Official Name and Position | Delinda Stiles (ASSISTANT OFFICE MANAGER) |
| Authorized Official Contact | 2052219351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jasper Family Practice Center Pc Po Box 1474 Jasper AL 35502-1474 Ph: (205) 221-9351 | Jasper Family Practice Center Pc 2201 N Airport Rd Jasper AL 35504-7058 Ph: (205) 221-9351 |
| NPI Number | 1275535361 |
|---|---|
| Provider Enumeration Date | 08/10/2005 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 2163494139 |
|---|---|
| Medicare Enrollment ID | O20040810000905 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275535361 | NPI | - | NPPES |
| 528601190 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Alabama) | Primary |
| Provider Name | Derrick Bowling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184626277 PECOS PAC ID: 2264474188 Enrollment ID: I20050601000377 |
| Provider Name | Katherine Bivona |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255482832 PECOS PAC ID: 9830293208 Enrollment ID: I20070326000251 |
| Provider Name | John S Bivona |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740338904 PECOS PAC ID: 1355445107 Enrollment ID: I20070403000628 |
| Provider Name | Rebekah Koza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396119244 PECOS PAC ID: 8729374210 Enrollment ID: I20160909000548 |
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Gastroenterologists Consultants Of Jasper, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3400 Highway 78 E, Medical Arts Tower Suite 504, Jasper, AL 35501 Phone: 205-295-9630 Fax: 205-296-9362 | |
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Hmc Rural Health Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2201 N Airport Rd, Jasper, AL 35504 Phone: 205-221-9351 Fax: 205-221-3700 | |
Boswell Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1325 Highway 195, Jasper, AL 35503 Phone: 205-302-0284 Fax: 205-302-0252 | |
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