| Wiregrass Behavioral Group LLC | |
|
256 Honeysuckle Rd Ste 12 Dothan AL 36305-1168 | |
| (334) 792-6736 | |
| (334) 792-6737 |
| Full Name | Wiregrass Behavioral Group LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 256 Honeysuckle Rd Ste 12, Dothan, Alabama |
| Authorized Official Name and Position | Phillip Johnson (PRESIDENT) |
| Authorized Official Contact | 3347926736 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wiregrass Behavioral Group LLC 256 Honeysuckle Rd Ste 12 Dothan AL 36305-1168 Ph: (334) 792-6736 | Wiregrass Behavioral Group LLC 256 Honeysuckle Rd Ste 12 Dothan AL 36305-1168 Ph: (334) 792-6736 |
| NPI Number | 1821609389 |
|---|---|
| Provider Enumeration Date | 08/10/2020 |
| Last Update Date | 08/13/2020 |
| Certification Date | 08/13/2020 |
| Medicare PECOS PAC ID | 6103244504 |
|---|---|
| Medicare Enrollment ID | O20200917000368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821609389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| Provider Name | Jimmie S Guyton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932664653 PECOS PAC ID: 3870833429 Enrollment ID: I20190319001948 |
| Provider Name | Alexia Kristianna Vasquez Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750053088 PECOS PAC ID: 4284001884 Enrollment ID: I20221111000900 |
| Provider Name | Courtney Brue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568006534 PECOS PAC ID: 0345612370 Enrollment ID: I20240725000752 |
| Provider Name | Frances M Espey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568755981 PECOS PAC ID: 5799223418 Enrollment ID: I20240813002673 |
| Provider Name | William Troy Elkington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790129252 PECOS PAC ID: 5698041036 Enrollment ID: I20250429001322 |
Wiregrass Wound Care Consultants LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1908 Fairview Ave, Dothan, AL 36301 Phone: 251-295-2815 Fax: 251-295-2815 |
Dothan Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1891 Honeysuckle Rd Ste 2a, Dothan, AL 36305 Phone: 334-794-6504 Fax: 334-793-4452 |
Primecare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4126 West Main Street, Dothan, AL 36305 Phone: 334-793-2120 Fax: 334-671-2930 |
Precision Wound Care LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 212 W Troy St Ste B, Dothan, AL 36303 Phone: 334-539-8418 |
Samc-houston Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1806 Fairview Ave, Dothan, AL 36301 Phone: 334-677-5986 Fax: 334-677-4901 |
Sasser Health LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3144 Ross Clark Cir, Dothan, AL 36303 Phone: 334-446-4712 |