| Hendricks Family Practice, Pc | |
|
2699 Sandlin Rd Sw Suite B-8 Decatur AL 35601-7343 | |
| (256) 301-0560 | |
| (256) 301-0563 |
| Full Name | Hendricks Family Practice, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2699 Sandlin Rd Sw, Decatur, Alabama |
| Authorized Official Name and Position | Malcolm R Hendricks (CO-OWNER/PHYSICIAN) |
| Authorized Official Contact | 2563010560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hendricks Family Practice, Pc 2699 Sandlin Rd Sw Suite B-8 Decatur AL 35601-7343 Ph: (256) 301-0560 | Hendricks Family Practice, Pc 2699 Sandlin Rd Sw Suite B-8 Decatur AL 35601-7343 Ph: (256) 301-0560 |
| NPI Number | 1568419810 |
|---|---|
| Provider Enumeration Date | 05/30/2006 |
| Last Update Date | 07/29/2020 |
| Medicare PECOS PAC ID | 6800968629 |
|---|---|
| Medicare Enrollment ID | O20080710000294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568419810 | NPI | - | NPPES |
| 102364 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 26531 (Alabama) | Primary |
| Provider Name | Tiffany M Hendricks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659312494 PECOS PAC ID: 8527068394 Enrollment ID: I20061228000369 |
| Provider Name | Malcolm R Hendricks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700823697 PECOS PAC ID: 5890797658 Enrollment ID: I20070207000192 |
| Provider Name | Brandi K Greeson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982169470 PECOS PAC ID: 5991048571 Enrollment ID: I20190522002596 |
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