Longleaf Primary Care, Llc | |
171 Town Center Dr Anniston AL 36205-4102 | |
(256) 237-1624 | |
Not Available |
Full Name | Longleaf Primary Care, Llc |
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Speciality | Family Medicine |
Location | 171 Town Center Dr, Anniston, Alabama |
Authorized Official Name and Position | Renee Davis (ADMINISTRATOR) |
Authorized Official Contact | 2562371624 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Longleaf Primary Care, Llc Po Box 5430 Anniston AL 36205-0430 Ph: (256) 237-1624 | Longleaf Primary Care, Llc 171 Town Center Dr Anniston AL 36205-4102 Ph: (256) 237-1624 |
NPI Number | 1255062832 |
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Provider Enumeration Date | 06/23/2022 |
Last Update Date | 06/23/2022 |
Medicare PECOS PAC ID | 4587030226 |
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Medicare Enrollment ID | O20221020000781 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255062832 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Howard E Mcveigh |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1356404776 PECOS PAC ID: 7719907732 Enrollment ID: I20090702000572 |
Provider Name | Hala Shama Mourtada |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417372509 PECOS PAC ID: 6608099528 Enrollment ID: I20140522000889 |
Provider Name | Bradley Elliott |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700267507 PECOS PAC ID: 7315255072 Enrollment ID: I20150929001864 |
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