Family & Community Medicine Associates LLC
Organization Active NPI Family Medicine Physician · Eufaula, AL
NPI 1467549634 · NPPES record last updated Jun 20, 2018
Key facts
- NPI
- 1467549634
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 24003 (AL)
- Legal business name
- FAMILY & COMMUNITY MEDICINE ASSOCIATES LLC
- Practice address
- 405 East Barbour Street
Suite 3
Eufaula, AL 36027-1701 - Phone
- (334) 687-0250
- Fax
- (334) 687-0299
- NPI assigned
- Oct 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Jesse Cornelius Haggerty III, MD, PHD
- Title
- Physician
- Phone
- (334) 687-0250
Other NPIs on the same Medicare enrollment 1
Practitioners 1
-
Jesse Cornelius Haggerty III, MD, MSC, MPH, PHD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110927000162 | AL | Part B Supplier - Clinic/Group Practice | 3173794989 |
Receives reassigned benefits from 1 practitioner 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Eufaula, AL |
National Provider Directory
Locations
405 E Barbour St
Ste 3
Eufaula, AL 36027
Phone (334) 687-0250
405 E Barbour St
#3
Eufaula, AL 36027
Phone (334) 687-0250
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 24003 | AL | Yes |
Addresses
Primary practice location
405 East Barbour Street
Suite 3
Eufaula, AL 36027-1701
Mailing address
405 East Barbour Street
Suite 3
Eufaula, AL 36027-1701
Phone (334) 687-0250
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51536749 | Other | AL | BCBS PROVIDER # |
| 009952520 | Medicaid | AL | |
| 131642 | Medicaid | AL | |
| 51501961 | Other | AL | BCBS PROVIDER # |
| 63-1271382 | Other | AL | TRICARE PROVIDER # |
| 51117736 | Other | AL | BCBS PROVIDER # |
Other names
- Jess C Haggerty III Sole Mbr
Other providers in Eufaula, AL
- Eufaula Family Chiropractic, P.C.
- Eufaula Family Medicine
- Eufaula MRI, LLC
- Eufaula Physical Therapy and Wellness, LLC
- Alissa Evans
- Family & Community Medicine Associates LLC
- Theresa Fillingim
- Allen D Finlayson
- Linda Joyce Floyd
- Focus Counseling LLC
All providers in Eufaula, AL · Family Medicine 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 Jun 20, 2018. 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.