| Fmc Medical Clinic - Fayette Llc | |
|
1653 Temple Ave N Ste 1 Fayette AL 35555-1314 | |
| (205) 932-1112 | |
| Not Available |
| Full Name | Fmc Medical Clinic - Fayette Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1653 Temple Ave N Ste 1, Fayette, 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 - Fayette Llc 1820 Rice Mine Rd N Ste 200 Tuscaloosa AL 35406-3282 Ph: (205) 333-4661 | Fmc Medical Clinic - Fayette Llc 1653 Temple Ave N Ste 1 Fayette AL 35555-1314 Ph: (205) 932-1112 |
| NPI Number | 1588141063 |
|---|---|
| Provider Enumeration Date | 07/26/2018 |
| Last Update Date | 10/08/2018 |
| Medicare PECOS PAC ID | 3375894041 |
|---|---|
| Medicare Enrollment ID | O20180919000668 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588141063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dana S Norris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356433064 PECOS PAC ID: 5991716870 Enrollment ID: I20060505000842 |
| Provider Name | David Call |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245233667 PECOS PAC ID: 6103878806 Enrollment ID: I20080512000441 |
| Provider Name | Ronald Evans |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255337770 PECOS PAC ID: 9830183490 Enrollment ID: I20111214000061 |
| Provider Name | Mark Randall |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831470426 PECOS PAC ID: 4385893007 Enrollment ID: I20121012000267 |
| Provider Name | Crystal A Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992253090 PECOS PAC ID: 2062795446 Enrollment ID: I20170208003065 |
| 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 |
Jon E. Sanford,m.d.,p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 122 17th Ct Ne, Fayette, AL 35555 Phone: 205-932-3900 Fax: 205-932-3941 | |
Martha Jo Christian Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1716 Temple Ave N, Fayette, AL 35555 Phone: 205-932-2497 Fax: 205-932-2539 | |
Frederick L. Yerby, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1716 Temple Ave N, Suite 6, Fayette, AL 35555 Phone: 205-932-7750 Fax: 205-932-6293 | |
Harold E. Breitling, Jr., M.d.p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1716 Temple Ave N, Suite 5, Fayette, AL 35555 Phone: 205-932-3978 Fax: 205-932-3990 | |
Family Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1705 1st Way Nw, Fayette, AL 35555 Phone: 205-932-7821 | |
Garry W Magouirk Mdpc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 110 23rd St Nw, Fayette, AL 35555 Phone: 205-932-3891 Fax: 205-932-3996 |