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ELBERTA CLINIC PC NPI 1588752844


NPI Information

NPI: 1588752844
Provider Name: ELBERTA CLINIC, PC

Other Name: ELBERTA FAMILY PRACTICE CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 01D0895119

Address:
24980 STATE ST
PO DRAWER 519
ELBERTA, AL
ZIP 36530
Phone: (251) 986-7301
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ELBERTA CLINIC, PC is a family medicine in Elberta, AL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ELBERTA CLINIC, PC NPI is 1588752844. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Elberta Family Practice Clinic.

The provider's business location address is:

24980 STATE ST
PO DRAWER 519
ELBERTA, AL
ZIP 36530-573
Phone: (251) 986-7301
Fax: (251) 986-5927

The provider's authorized official is Terry A. Kurtts .
The authorized official title is Owner and has the following contact phone number (251) 986-7301.

The CLIA number assigned to this NPI record is 01D0895119 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/11/2006 and was last updated on 2/20/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes
2207R00000XInternal MedicineNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1529500390MEDICAIDALABAMA
2BCBSOTHERALABAMABLUE CROSS BLUE SHIELD AL
3CN3899OTHERALABAMARAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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