FORT MITCHELL CLINIC PC NPI 1568748242

NPI Information

  • NPI: 1568748242
  • Provider Name: FORT MITCHELL CLINIC PC
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Other Name: PREFERRED MEDICAL GROUP
  • CLIA Number: 11D2322519
  • Address: 2 GILMORE RD
    FT MITCHELL, AL
    ZIP 36856
  • Phone: (334) 664-0463

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NPI Details

FORT MITCHELL CLINIC PC is a rural health clinic center in Ft Mitchell, AL. FORT MITCHELL CLINIC PC NPI is 1568748242. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Preferred Medical Group.

The provider's business location address is:

2 GILMORE RD
FT MITCHELL, AL
ZIP 36856-411
Phone: (334) 664-0463
Fax: (334) 664-0466

The provider's authorized official is Rajiv L Srivastava .
The authorized official title is Administrator and has the following contact phone number (334) 664-0463.

The CLIA number assigned to this NPI record is 11D2322519 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/26/2011 and was last updated on 6/9/2017.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207L00000XAnesthesiologyALABAMANo
2207Q00000XFamily MedicineMD7157ALABAMANo
3208000000XPediatricsMD26862ALABAMANo
4261Q00000XClinic/CenterMD26862ALABAMANo
5363LF0000XNurse PractitionerFamily1-129486ALABAMANo
6261QR1300XClinic/CenterRural Health013962ALABAMAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1013962MEDICARE UPIN
2133816MEDICAIDALABAMA

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: 11/21/2025

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