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Organization

CLARKE COUNTY FAMILY PRACTICE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DINAH PRITCHETT CRNP (OFFICE MANAGER)
(334) 636-5311
Entity
Organization

Contact information

Practice address
33650 HIGHWAY 43, SUITE 300, THOMASVILLE, AL 36784-3336
(334) 636-0757
(334) 636-0760
Mailing address
33650 HIGHWAY 43, SUITE 300, THOMASVILLE, AL 36784-3336
(334) 636-0757
(334) 636-0760

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00026983
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
515-35275
BCBS OF ALABAMA
AL
Enumeration date
08/22/2006
Last updated
07/17/2007
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