| Fmc Medical Clinic - Berry Llc | |
|
32 School Ave Berry AL 35546-2246 | |
| (205) 689-0909 | |
| Not Available |
| Full Name | Fmc Medical Clinic - Berry Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 32 School Ave, Berry, Alabama |
| Authorized Official Name and Position | Daniel Clay Conville (CORP DIRECTOR, PHYSICIAN SERVICES) |
| Authorized Official Contact | 2057596165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fmc Medical Clinic - Berry Llc 3901 Greensboro Ave Ste A Tuscaloosa AL 35405-3771 Ph: (205) 759-6165 | Fmc Medical Clinic - Berry Llc 32 School Ave Berry AL 35546-2246 Ph: (205) 689-0909 |
| NPI Number | 1588376800 |
|---|---|
| Provider Enumeration Date | 12/19/2022 |
| Last Update Date | 12/19/2022 |
| Medicare PECOS PAC ID | 5890167696 |
|---|---|
| Medicare Enrollment ID | O20230203001180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588376800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dakota Acton-jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790167864 PECOS PAC ID: 1153638192 Enrollment ID: I20181017002326 |
| Provider Name | Kristin Moudry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720568363 PECOS PAC ID: 6002150711 Enrollment ID: I20181206003578 |