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918 Drayton Ave Elba AL 36323-1448 | |
(334) 897-2207 | |
(334) 897-3476 |
Full Name | |
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Speciality | Family Medicine |
Location | 918 Drayton Ave, Elba, Alabama |
Authorized Official Name and Position | Ellen C Briley (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 3348972257 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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918 Drayton Ave Elba AL 36323-1448 Ph: (334) 897-2207 | 918 Drayton Ave Elba AL 36323-1448 Ph: (334) 897-2207 |
NPI Number | 1972653210 |
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Provider Enumeration Date | 01/11/2007 |
Last Update Date | 12/30/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972653210 | NPI | - | NPPES |
0510078620 | Other | AL | BCBS OF AL |
009918640 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 10790 (Alabama) | Primary |
Mizell Memorial Hospital, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 918 Drayton Ave, Elba, AL 36323 Phone: 334-493-5713 | |