South Alabama Family Care, Llc | |
10067 Grand Bay Wilmer Rd S Ste 100 Grand Bay AL 36541-5003 | |
(251) 810-9525 | |
(251) 810-9536 |
Full Name | South Alabama Family Care, Llc |
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Speciality | Family Medicine |
Location | 10067 Grand Bay Wilmer Rd S Ste 100, Grand Bay, Alabama |
Authorized Official Name and Position | Bridgot Peters (BILLING DIRECTOR) |
Authorized Official Contact | 2514457618 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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South Alabama Family Care, Llc 10075 Grand Bay Wilmer Rd S Grand Bay AL 36541-5003 Ph: (251) 865-1852 | South Alabama Family Care, Llc 10067 Grand Bay Wilmer Rd S Ste 100 Grand Bay AL 36541-5003 Ph: (251) 810-9525 |
NPI Number | 1649028960 |
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Provider Enumeration Date | 05/10/2024 |
Last Update Date | 07/23/2024 |
Medicare PECOS PAC ID | 0042754715 |
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Medicare Enrollment ID | O20240705000929 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649028960 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |
Provider Name | Robert E Vickers |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1982611158 PECOS PAC ID: 8022919448 Enrollment ID: I20050715000546 |
Provider Name | Lloyd S Stokes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457546319 PECOS PAC ID: 6204915556 Enrollment ID: I20080512000385 |
Provider Name | Darren Waters |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1568419661 PECOS PAC ID: 9830293406 Enrollment ID: I20081017000005 |
Provider Name | Timothy Hughes |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1740223742 PECOS PAC ID: 0143240135 Enrollment ID: I20191118001053 |
Provider Name | Andrew Rockwell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447887567 PECOS PAC ID: 1355771932 Enrollment ID: I20200422001950 |
Provider Name | Justin Stokes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932674975 PECOS PAC ID: 7517386691 Enrollment ID: I20200923003183 |
Provider Name | Parath Knight |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558938282 PECOS PAC ID: 1557765328 Enrollment ID: I20210802003053 |
Provider Name | Tiffany Franklin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568045060 PECOS PAC ID: 4688079379 Enrollment ID: I20210818001931 |
Provider Name | Colten Lander |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588382915 PECOS PAC ID: 4486021862 Enrollment ID: I20221028000950 |
Gulf Coast Treatment Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12271 Interchange Rd., Grand Bay, AL 36541 Phone: 251-865-0123 Fax: 251-865-0247 | |
Grand Bay Medical Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10075 Grand Bay Wilmer Rd S, Grand Bay, AL 36541 Phone: 251-865-9111 |