| Hww | |
|
4358 Old Shell Rd Ste 177b Mobile AL 36608-2050 | |
| (251) 298-7111 | |
| (251) 626-9615 |
| Full Name | Hww |
|---|---|
| Speciality | Clinic/Center |
| Location | 4358 Old Shell Rd Ste 177b, Mobile, Alabama |
| Authorized Official Name and Position | Tyrone Cornelle Barnes (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 2516231933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hww 4358 Old Shell Rd Ste 177b Mobile AL 36608-2050 Ph: (251) 298-7111 | Hww 4358 Old Shell Rd Ste 177b Mobile AL 36608-2050 Ph: (251) 298-7111 |
| NPI Number | 1255150280 |
|---|---|
| Provider Enumeration Date | 10/07/2024 |
| Last Update Date | 11/07/2024 |
| Certification Date | 11/07/2024 |
| Medicare PECOS PAC ID | 8921535949 |
|---|---|
| Medicare Enrollment ID | O20250102001713 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255150280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Tyrone Cornelle Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427751536 PECOS PAC ID: 0244605665 Enrollment ID: I20230417000791 |
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