| Dysautonomia Mvp Center, Llc. | |
|
2470 Rocky Ridge Rd Suite 200 Vestavia AL 35243-2833 | |
| (205) 529-5658 | |
| Not Available |
| Full Name | Dysautonomia Mvp Center, Llc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2470 Rocky Ridge Rd, Vestavia, Alabama |
| Authorized Official Name and Position | Kimberlee F Smith (OFFICE MANAGER) |
| Authorized Official Contact | 2054674969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dysautonomia Mvp Center, Llc. 2470 Rocky Ridge Rd Suite 200 Vestavia AL 35243-2833 Ph: (205) 467-4969 | Dysautonomia Mvp Center, Llc. 2470 Rocky Ridge Rd Suite 200 Vestavia AL 35243-2833 Ph: (205) 529-5658 |
| NPI Number | 1518359025 |
|---|---|
| Provider Enumeration Date | 02/21/2015 |
| Last Update Date | 02/21/2015 |
| Medicare PECOS PAC ID | 7012238314 |
|---|---|
| Medicare Enrollment ID | O20150611000493 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518359025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9924 (Alabama) | Secondary |
| 207R00000X | Internal Medicine | 14740 (Alabama) | Primary |
| Provider Name | Meleah B Yates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346516127 PECOS PAC ID: 5597927988 Enrollment ID: I20120501000512 |
| Provider Name | Paula D Moore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952452260 PECOS PAC ID: 0648424838 Enrollment ID: I20130218000465 |
| Provider Name | Ginger Hitchler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083003347 PECOS PAC ID: 1557629730 Enrollment ID: I20171215001549 |
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