| Saraland Family Pract Pc | |
|
119 Ennis St Saraland AL 36571-2706 | |
| (251) 544-2000 | |
| (251) 544-2004 |
| Full Name | Saraland Family Pract Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 119 Ennis St, Saraland, Alabama |
| Authorized Official Name and Position | Mark A Mcdaniel (MD/OWNER) |
| Authorized Official Contact | 2515442000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saraland Family Pract Pc 119 Ennis St Saraland AL 36571-2706 Ph: (251) 544-2000 | Saraland Family Pract Pc 119 Ennis St Saraland AL 36571-2706 Ph: (251) 544-2000 |
| NPI Number | 1477664779 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/10/2007 |
| Medicare PECOS PAC ID | 7618973488 |
|---|---|
| Medicare Enrollment ID | O20070830000005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477664779 | NPI | - | NPPES |
| K961 | Other | MEDICARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 00012136 (Alabama) | Primary |
| Provider Name | Mark A Mcdaniel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518997014 PECOS PAC ID: 4284630690 Enrollment ID: I20061018000627 |
| Provider Name | Courtney M Nix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093130205 PECOS PAC ID: 3173746351 Enrollment ID: I20140514002465 |
| Provider Name | Leah Kimberly Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891409330 PECOS PAC ID: 2668838467 Enrollment ID: I20230522001124 |
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