| |
106 Edwina St Evergreen AL 36401-3319 | |
(251) 578-4300 | |
(251) 578-4307 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 106 Edwina St, Evergreen, Alabama |
Authorized Official Name and Position | James Powell (CLINIC MANAGER) |
Authorized Official Contact | 2515784300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
106 Edwina Street Evergreen AL 36401 Ph: (251) 578-4300 | 106 Edwina St Evergreen AL 36401-3319 Ph: (251) 578-4300 |
NPI Number | 1952466211 |
---|---|
Provider Enumeration Date | 12/27/2006 |
Last Update Date | 06/13/2022 |
Medicare PECOS PAC ID | 2365541844 |
---|---|
Medicare Enrollment ID | O20070625000251 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952466211 | NPI | - | NPPES |
529932932 | Medicaid | AL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Mark A Roberts |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275565442 PECOS PAC ID: 8022117506 Enrollment ID: I20070625000235 |
Provider Name | Jessica R Pierce |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063918118 PECOS PAC ID: 3072862812 Enrollment ID: I20180828000530 |
Provider Name | Whitley R Harper |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528653409 PECOS PAC ID: 3274753587 Enrollment ID: I20220825002855 |
Barnes Family Medical Associates Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 680 West Front St, Evergreen, AL 36401 Phone: 251-578-5111 Fax: 251-578-5991 | |
Stephen M West Md Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 680 West Front St, Evergreen, AL 36401 Phone: 251-578-5111 Fax: 251-578-5991 | |
Helen Scharko, M.d. , Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Edwina St, Evergreen, AL 36401 Phone: 251-578-0220 Fax: 251-578-0223 | |