| Premier Family Care, Llc | |
|
2017 Obrig Ave Guntersville AL 35976-2156 | |
| (256) 582-2324 | |
| (256) 582-2321 |
| Full Name | Premier Family Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2017 Obrig Ave, Guntersville, Alabama |
| Authorized Official Name and Position | Jess H Youngblood (OWNER) |
| Authorized Official Contact | 2565822324 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Family Care, Llc 2017 Obrig Ave Guntersville AL 35976-2156 Ph: (256) 582-2324 | Premier Family Care, Llc 2017 Obrig Ave Guntersville AL 35976-2156 Ph: (256) 582-2324 |
| NPI Number | 1831493675 |
|---|---|
| Provider Enumeration Date | 01/10/2011 |
| Last Update Date | 01/10/2011 |
| Medicare PECOS PAC ID | 5597959767 |
|---|---|
| Medicare Enrollment ID | O20110218000312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831493675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jess H Youngblood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467676676 PECOS PAC ID: 4688767650 Enrollment ID: I20070906000796 |
| Provider Name | James Russell Hutcherson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477756542 PECOS PAC ID: 9537249610 Enrollment ID: I20080102000019 |
| Provider Name | Larry R Johnston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023003019 PECOS PAC ID: 2961694740 Enrollment ID: I20101012000813 |
| Provider Name | Kristy L Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447798616 PECOS PAC ID: 9739456658 Enrollment ID: I20170525000690 |
| Provider Name | Jennifer T Tootle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477079952 PECOS PAC ID: 2264790450 Enrollment ID: I20171215002193 |
| Provider Name | Tiaya A Lang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467978221 PECOS PAC ID: 7214285865 Enrollment ID: I20180730002936 |
| Provider Name | John Paul Mizelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174099279 PECOS PAC ID: 9739426321 Enrollment ID: I20190118002655 |
| Provider Name | Allison F Brewster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538698964 PECOS PAC ID: 3072848506 Enrollment ID: I20190705000358 |
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Lakeside North Family Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 38 Rowe Dr, Guntersville, AL 35976 Phone: 256-571-8460 Fax: 256-571-8464 | |
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