Lakeland Physicians LLC
Organization Active NPI Family Medicine Physician · Haleyville, AL
NPI 1851780951 · NPPES record last updated Feb 18, 2015
Key facts
- NPI
- 1851780951
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- LAKELAND PHYSICIANS LLC
- Practice address
- 42030 Highway 195
Ste a
Haleyville, AL 35565-7054 - Phone
- (205) 485-7243
- Fax
- (205) 485-7244
- NPI assigned
- Jan 13, 2015
- Organization subpart
- No
Authorized official
- Name
- Steve Clapp
- Title
- President
- Phone
- (205) 485-7243
Member of 1
Practitioners 57
-
Jorge Blanco, MD
-
Joel L Bridgewater, M.D.
-
Derek Sloane Cannon, M.D.
-
Mark H Christensen, M.D.
-
Thomas Stephen Christian, M.D.
-
Diane R Counce, MD
-
Tamer M Elsayed, MD
-
Martin M Hajjar, MD
-
Adam S Harris, MD
-
Vernon S Hurst, MD
-
Minh Huu Nguyen Huynh, M.D.
-
Inkil Hwangpo, DO
-
Jason P Lockette, M.D.
-
Gilbert Reid Melson III, D.O.
-
Matthew Tyler Melson, D.O.
-
Karen L Moore, CRNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150408000559 | AL | Part B Supplier - Clinic/Group Practice | 0446578298 |
Receives reassigned benefits from 56 practitioners Practice locations: Haleyville, AL; Lynn, AL |
National Provider Directory
Locations
42030 Highway 195
Ste A
Haleyville, AL 35565
Phone (205) 485-7227
42030 Highway 195
Haleyville, AL 35565
Phone (205) 485-7227
22014 Highway 5
Lynn, AL 35575
Phone (205) 485-7113
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | |||
| Family Medicine Physician |
207Q00000X | Yes | ||
| Geriatric Psychiatry Physician |
2084P0805X |
Addresses
Primary practice location
42030 Highway 195
Ste a
Haleyville, AL 35565-7054
Mailing address
42030 Highway 195
Ste a
Haleyville, AL 35565-7054
Phone (205) 485-7243
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 168737 | Medicaid | AL |
Other providers in Haleyville, AL
- Lakeland Community Hospital, Inc.
- Lakeland Community Hospital, Inc.
- Lakeland Physician Practices LLC
- Lakeland Physician Practices LLC
- Lakeland Physician Practices LLC
- Dan M Lakeman
- Frances Evangeline Lane
- Jordan Lawler
- Hank Sung Lee
- Tara Lindsey
All providers in Haleyville, 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 Feb 18, 2015. 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.