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1080 Red Fox Rd W Mount Vernon AL 36560-2629 | |
(251) 829-9023 | |
(855) 933-1195 |
Full Name | |
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Speciality | Family Medicine |
Location | 1080 Red Fox Rd W, Mount Vernon, Alabama |
Authorized Official Name and Position | Lebaron Byrd (CHIEF) |
Authorized Official Contact | 2517860829 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1080 Red Fox Rd W Mount Vernon AL 36560-2629 Ph: (251) 786-0829 | 1080 Red Fox Rd W Mount Vernon AL 36560-2629 Ph: (251) 829-9023 |
NPI Number | 1336907948 |
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Provider Enumeration Date | 03/08/2024 |
Last Update Date | 04/17/2024 |
Medicare PECOS PAC ID | 8921540311 |
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Medicare Enrollment ID | O20240613001147 |
Identifier | Type | State | Issuer |
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1336907948 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Rahel Aziz |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1902354277 PECOS PAC ID: 7810273976 Enrollment ID: I20170404002575 |