| Mmc, M.d., Llc | |
|
3509 Watermelon Rd Northport AL 35473-5174 | |
| (205) 366-0221 | |
| Not Available |
| Full Name | Mmc, M.d., Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3509 Watermelon Rd, Northport, Alabama |
| Authorized Official Name and Position | Mary M Clapp (OWNER) |
| Authorized Official Contact | 2053660221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mmc, M.d., Llc 1110 Dr Edward Hillard Dr Ste A Tuscaloosa AL 35401-7446 Ph: (205) 333-4655 | Mmc, M.d., Llc 3509 Watermelon Rd Northport AL 35473-5174 Ph: (205) 366-0221 |
| NPI Number | 1316559917 |
|---|---|
| Provider Enumeration Date | 08/17/2020 |
| Last Update Date | 12/17/2020 |
| Medicare PECOS PAC ID | 5698193886 |
|---|---|
| Medicare Enrollment ID | O20200921001964 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316559917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Mary M Clapp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982041463 PECOS PAC ID: 6709019227 Enrollment ID: I20160912001451 |
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