Wiregrass Clinic Llc | |
4300 W Main St Ste 405 Dothan AL 36305-1086 | |
(334) 944-7073 | |
(334) 944-7058 |
Full Name | Wiregrass Clinic Llc |
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Speciality | Family Medicine |
Location | 4300 W Main St Ste 405, Dothan, Alabama |
Authorized Official Name and Position | Jennifer L Jackson (SR DIR PROV ENROLLMENT & ONBOARDING) |
Authorized Official Contact | 6154653334 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Wiregrass Clinic Llc Po Box 689022 Franklin TN 37068-9022 Ph: (615) 465-7230 | Wiregrass Clinic Llc 4300 W Main St Ste 405 Dothan AL 36305-1086 Ph: (334) 944-7073 |
NPI Number | 1851063432 |
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Provider Enumeration Date | 10/01/2021 |
Last Update Date | 10/01/2021 |
Identifier | Type | State | Issuer |
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1851063432 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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