Wilmer Medical Clinic, Llc | |
6353 2nd Street Wilmer AL 36587 | |
(251) 865-1852 | |
Not Available |
Full Name | Wilmer Medical Clinic, Llc |
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Speciality | Internal Medicine |
Location | 6353 2nd Street, Wilmer, Alabama |
Authorized Official Name and Position | Lloyd S Stokes (MANAGING PARTNER) |
Authorized Official Contact | 2518651852 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wilmer Medical Clinic, Llc 10075 Grand Bay Wilmer Rd S Grand Bay AL 36541-5003 Ph: (251) 865-1852 | Wilmer Medical Clinic, Llc 6353 2nd Street Wilmer AL 36587 Ph: (251) 865-1852 |
NPI Number | 1649667577 |
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Provider Enumeration Date | 04/17/2015 |
Last Update Date | 10/26/2015 |
Medicare PECOS PAC ID | 4385954379 |
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Medicare Enrollment ID | O20151103001918 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649667577 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |
Provider Name | Kristina E Ray |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1598831422 PECOS PAC ID: 3779677596 Enrollment ID: I20070924000360 |
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 | Jonathan A Dean |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952545444 PECOS PAC ID: 2668638495 Enrollment ID: I20120724000345 |
Provider Name | Penny X Dupre |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1417117664 PECOS PAC ID: 2264673219 Enrollment ID: I20151112000722 |
Provider Name | Deanna Seaman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215447750 PECOS PAC ID: 5991050478 Enrollment ID: I20180625002630 |
Provider Name | Kristina Miller |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710550611 PECOS PAC ID: 0446658082 Enrollment ID: I20211012000882 |
Provider Name | Sybil Raye Poiroux |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881321784 PECOS PAC ID: 1254709686 Enrollment ID: I20221116001353 |
Provider Name | Stephanie Hautau |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326804725 PECOS PAC ID: 3971941220 Enrollment ID: I20240404003378 |
Kray Medical, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6353 2nd St, Wilmer, AL 36587 Phone: 251-753-4008 |