| Primecare | |
|
4126 West Main Street Dothan AL 36305-9310 | |
| (334) 793-2120 | |
| (334) 671-2930 |
| Full Name | Primecare |
|---|---|
| Speciality | Clinic/Center |
| Location | 4126 West Main Street, Dothan, Alabama |
| Authorized Official Name and Position | Christie M Mclean (ADMINISTRATOR) |
| Authorized Official Contact | 3347932120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primecare Po Box 8397 Dothan AL 36304-0397 Ph: (334) 793-2120 | Primecare 4126 West Main Street Dothan AL 36305-9310 Ph: (334) 793-2120 |
| NPI Number | 1013199074 |
|---|---|
| Provider Enumeration Date | 12/03/2007 |
| Last Update Date | 12/04/2009 |
| Medicare PECOS PAC ID | 3173605102 |
|---|---|
| Medicare Enrollment ID | O20080130000452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013199074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Michael A Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679542740 PECOS PAC ID: 6800798646 Enrollment ID: I20040122001024 |
| Provider Name | Emily Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326016445 PECOS PAC ID: 5890750947 Enrollment ID: I20050929000507 |
| Provider Name | Mathew G Krista |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093779738 PECOS PAC ID: 2961403001 Enrollment ID: I20070116000565 |
| Provider Name | Yusef Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699904243 PECOS PAC ID: 5597911487 Enrollment ID: I20120808000770 |
| Provider Name | Brandy Michelle Bodiford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942466073 PECOS PAC ID: 0446431654 Enrollment ID: I20141106000705 |
| Provider Name | Valerie Thomley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831570670 PECOS PAC ID: 6406164490 Enrollment ID: I20150924000664 |
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