| Douglas Van Wilson, CRNP | |
|
47344 Us Highway 78, Lincoln, AL 35096-6748 | |
| (205) 763-7848 | |
| Not Available |
| Full Name | Douglas Van Wilson |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 6 Years |
| Location | 47344 Us Highway 78, Lincoln, Alabama |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407417538 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 1-107799 (Alabama) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Fast Pace Medical Clinic Pllc | 5395881841 | 680 |
| Entity Name | Baptist Health Centers Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265496236 PECOS PAC ID: 3476457011 Enrollment ID: O20180124001442 |
| Entity Name | Fast Pace Medical Clinic Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639679962 PECOS PAC ID: 5395881841 Enrollment ID: O20200415001560 |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas Van Wilson, CRNP 1130 22nd St S Ste 1000, Birmingham, AL 35205-2881 Ph: () - | Douglas Van Wilson, CRNP 47344 Us Highway 78, Lincoln, AL 35096-6748 Ph: (205) 763-7848 |
Ariel Carpenter, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1800 Honda Dr, Lincoln, AL 35096 Phone: 205-355-6850 | |
Christy Hill Fuller, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 47344 Us Highway 78, Lincoln, AL 35096 Phone: 205-763-7848 Fax: 205-763-7235 | |
Misty Lawley Ralyea, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 47344 Us Highway 78, Lincoln, AL 35096 Phone: 205-763-7848 Fax: 205-763-7235 | |
Brenda P Bynum, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 47344 Us Highway 78, Lincoln, AL 35096 Phone: 205-763-7848 Fax: 205-763-7235 |