| Waddell Center Family Medicine | |
|
902 W Washington St Athens AL 35611-2438 | |
| (256) 216-9777 | |
| (256) 216-9776 |
| Full Name | Waddell Center Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 902 W Washington St, Athens, Alabama |
| Authorized Official Name and Position | Sebrina B Holt (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2562169648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waddell Center Family Medicine 902 W Washington St Athens AL 35611-2438 Ph: (256) 216-9777 | Waddell Center Family Medicine 902 W Washington St Athens AL 35611-2438 Ph: (256) 216-9777 |
| NPI Number | 1104353226 |
|---|---|
| Provider Enumeration Date | 05/19/2017 |
| Last Update Date | 01/05/2024 |
| Medicare PECOS PAC ID | 3577832542 |
|---|---|
| Medicare Enrollment ID | O20170706002696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104353226 | NPI | - | NPPES |
| PENDING | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | William Woodall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720298375 PECOS PAC ID: 3779658240 Enrollment ID: I20080818000600 |
| Provider Name | Samantha Clark Ross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700089893 PECOS PAC ID: 1658495908 Enrollment ID: I20100824000591 |
| Provider Name | Neha K Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871871517 PECOS PAC ID: 9739358466 Enrollment ID: I20110812000641 |
| Provider Name | Melissa C Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215298849 PECOS PAC ID: 9830355445 Enrollment ID: I20120726000387 |
| Provider Name | Jaclyn Collie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922509520 PECOS PAC ID: 2365799632 Enrollment ID: I20180717004094 |
| Provider Name | Phillip R Ingram |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255950994 PECOS PAC ID: 7315360005 Enrollment ID: I20230629000775 |
Waddell Center Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 902 W Washington St, Athens, AL 35611 Phone: 256-216-9777 | |
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