| Mcmd Llc | |
|
22292 Us Highway 72 Athens AL 35613-2604 | |
| (256) 614-2444 | |
| Not Available |
| Full Name | Mcmd Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 22292 Us Highway 72, Athens, Alabama |
| Authorized Official Name and Position | Matthew Bragg Caldwell (PHYSICIAN) |
| Authorized Official Contact | 2566142444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcmd Llc 22292 Us Highway 72 Athens AL 35613-2604 Ph: (256) 614-2444 | Mcmd Llc 22292 Us Highway 72 Athens AL 35613-2604 Ph: (256) 614-2444 |
| NPI Number | 1477068468 |
|---|---|
| Provider Enumeration Date | 12/12/2017 |
| Last Update Date | 03/16/2022 |
| Medicare PECOS PAC ID | 7618222597 |
|---|---|
| Medicare Enrollment ID | O20180618001117 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477068468 | NPI | - | NPPES |
| 32665 | Other | AL | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 32665 (Alabama) | Primary |
| Provider Name | Matthew Bragg Caldwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619236064 PECOS PAC ID: 7719200591 Enrollment ID: I20141231001221 |
| Provider Name | Holly S Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215688916 PECOS PAC ID: 9234593237 Enrollment ID: I20230908002940 |
| Provider Name | Jaime H Willey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710691209 PECOS PAC ID: 5698120624 Enrollment ID: I20231011003497 |
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