Dale Medical Center
Organization Active NPI Surgery Physician · Ozark, AL
NPI 1366724684 · NPPES record last updated Mar 4, 2025
Key facts
- NPI
- 1366724684
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- License
- 25234 (AL)
- Legal business name
- DALE MEDICAL CENTER
- Practice address
- 2126 W Roy Parker Rd Ste 203
Ozark, AL 36360-8566 - Phone
- (344) 431-3633
- Fax
- (344) 431-3653
- NPI assigned
- Sep 13, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- DALE MEDICAL CENTER
Authorized official
- Name
- Mr. Rick Wright, CFO
- Title
- Chief Financial Officer
- Phone
- (334) 774-2601
Other NPIs on the same Medicare enrollment 14
Practitioners 17
-
Radu Constantine, M.D.
-
Patricia Diane Brewer, FNP-BC, CRNP
-
Leslie Kristine Canfield, CRNP
-
Mark Brian Ellis, D.O.
-
Leslie Ann Ethridge, CRNP, FNP
-
Morgan Lindsay Hammock, CRNP
-
Margaret J. Hughes, CRNP
-
Vinson Lewis Johnson, CRNP
-
Marylynn W. Parker, M.D.
-
Rifat Parwaiz, M.D.
-
Kayla Brooke Russell, FNP-C
-
Sheryl A. Jernigan, ARNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031107000202 | AL | Part B Supplier - Clinic/Group Practice | 3476466327 |
Receives reassigned benefits from 47 practitioners 14 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Ozark, AL |
National Provider Directory
- Part of
- United Probill
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | 25234 | AL | Yes |
Addresses
Primary practice location
2126 W Roy Parker Rd Ste 203
Ozark, AL 36360-8566
Mailing address
PO Box 863
Ozark, AL 36361-0863
Phone (334) 774-2601
Other names
- Dale Surgical Group
Other providers in Ozark, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2025. 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.