Andalusia Physician Practices LLC
Organization Active NPI Orthopaedic Surgery Physician · Andalusia, AL
NPI 1306131834 · NPPES record last updated Feb 9, 2023
Key facts
- NPI
- 1306131834
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- ANDALUSIA PHYSICIAN PRACTICES LLC
- Practice address
- 301 Medical Avenue
Suite C
Andalusia, AL 36420 - Phone
- (334) 222-4449
- Fax
- (334) 222-4450
- NPI assigned
- Jun 13, 2011
- Organization subpart
- No
Authorized official
- Name
- Kathy J Teague
- Title
- Vice President, Corporate Secretary
- Phone
- (629) 253-5121
Other NPIs on the same Medicare enrollment 3
Practitioners 13
-
Pamela Nancy Barber, M.D.
-
Marc Chatman, CRNP
-
Holli Hinote Johnson, CRNP
-
Connie Jeanine Lasley, CRNP
-
Heath A. Parker, D.O.
-
Richard Allen Roller, MD, PHD
-
Breena Reid Till, CRNP
-
Grover Ashton Wells III, M.D.
-
Tonya Wynette Wright, CRNP
-
Elizabeth Tucker, MD
-
Robert Lawrence Long, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070425000603 | AL | Part B Supplier - Clinic/Group Practice | 7315043007 |
Receives reassigned benefits from 47 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Andalusia, AL; Opp, AL; Evergreen, AL; Brewton, AL |
National Provider Directory
Locations
300 Medical Ave
Ste 100
Andalusia, AL 36420
Phone (334) 222-2393
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
301 Medical Avenue
Suite C
Andalusia, AL 36420
Mailing address
301 Medical Avenue
Suite C
Andalusia, AL 36420
Phone (334) 222-4449
Other names
- Andalusia Orthopedics
Other providers in Andalusia, AL
- Andalusia Eye Clinic LLC
- Andalusia Greater Regional Otolaryngology ENT P C
- Andalusia Health Care LLC
- Andalusia Manor LLC
- Andalusia Neurology PC
- Andalusia Physician Practices LLC
- Andalusia Physician Practices LLC
- Andalusia Physician Practices LLC
- Andalusia Physician Practices LLC
- Andalusia Professional Services LLC
All providers in Andalusia, AL · Orthopaedic Surgery Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.