| Optimum Health Primary Care Llc | |
|
1878 Jeff Rd Nw Ste A Huntsville AL 35806-4261 | |
| (256) 562-8773 | |
| Not Available |
| Full Name | Optimum Health Primary Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1878 Jeff Rd Nw Ste A, Huntsville, Alabama |
| Authorized Official Name and Position | Elisicia Jiles (MD) |
| Authorized Official Contact | 2562515002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimum Health Primary Care Llc 1878 Jeff Rd Nw Ste A Huntsville AL 35806-4261 Ph: (256) 251-5002 | Optimum Health Primary Care Llc 1878 Jeff Rd Nw Ste A Huntsville AL 35806-4261 Ph: (256) 562-8773 |
| NPI Number | 1316646482 |
|---|---|
| Provider Enumeration Date | 02/28/2023 |
| Last Update Date | 07/14/2023 |
| Medicare PECOS PAC ID | 4688039357 |
|---|---|
| Medicare Enrollment ID | O20230502002208 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316646482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Elisicia L Jiles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518258433 PECOS PAC ID: 8224259403 Enrollment ID: I20190730004510 |
| Provider Name | Danielle Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043699937 PECOS PAC ID: 7719228212 Enrollment ID: I20210825001034 |
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