| Mr Pedro Dejesus Polanco, MD | |
|
725 East Coy Smith Highway, Mt Vernon, AL 36560 | |
| (251) 662-6700 | |
| (251) 829-5385 |
| Full Name | Mr Pedro Dejesus Polanco |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 725 East Coy Smith Highway, Mt Vernon, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972511855 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | L2714 (Alabama) | Primary |
| Entity Name | State Of Alabama Department Of Finance |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619190998 PECOS PAC ID: 5698684090 Enrollment ID: O20031205000194 |
| Entity Name | River Region Psychiatry Associates, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386891497 PECOS PAC ID: 1254491012 Enrollment ID: O20081124000448 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Pedro Dejesus Polanco, MD Po Box 1090, 725 East Coy Smith Highway, Mt Vernon, AL 36560 Ph: (251) 662-6700 | Mr Pedro Dejesus Polanco, MD 725 East Coy Smith Highway, Mt Vernon, AL 36560 Ph: (251) 662-6700 |
Dr. Shelby G Bruton, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 725 East Coy Smith Highway, Mt Vernon, AL 36560 Phone: 251-662-6700 Fax: 251-829-5385 | |
Miss Rajani S Joshi, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 725 East Coy Smith Highway, Mt Vernon, AL 36560 Phone: 251-662-6700 Fax: 251-829-5385 |