Dale Medical Center
Organization Active NPI Internal Medicine Physician · Ozark, AL
NPI 1659533206 · NPPES record last updated Apr 15, 2010
Key facts
- NPI
- 1659533206
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 28100 (AL)
- Legal business name
- DALE MEDICAL CENTER
- Practice address
- 218 Hospital Ave
Suite B
Ozark, AL 36360-2064 - Phone
- (334) 774-5864
- Fax
- (334) 774-1437
- NPI assigned
- Jun 25, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- DALE MEDICAL CENTER
Authorized official
- Name
- Mr. Vernon Johnson
- Title
- Ceo
- Phone
- (334) 774-2601
Other NPIs on the same Medicare enrollment 14
Corporate family (same tax ID) 12
Practitioners 1
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
- Tax ID family
- United Probill
- Part of
- United Probill
Locations
218 Hospital Ave
Ozark, AL 36360
Phone (334) 774-1982
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | 28100 | AL | Yes |
Addresses
Primary practice location
218 Hospital Ave
Suite B
Ozark, AL 36360-2064
Mailing address
PO Box 863
Ozark, AL 36361-0863
Phone (334) 774-5864
Other names
- Oliver W Crawford Jr
Other providers in Ozark, AL
- Dale Medical Center
- Dale Medical Center
- Dale Medical Center
- Dale Medical Center
- Dale Medical Center
- Dale Medical Center
- Dale Medical Center
- Dale Medical Center
- Dale Medical Center
- Dale Medical Center
All providers in Ozark, AL · Internal 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 Apr 15, 2010. 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.