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Organization

PRATTVILLE PRIMARY CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANNY P INGRAM MD (PRESIDENT)
(334) 365-2205
Entity
Organization

Contact information

Practice address
461 E MAIN STREET, PRATTVILLE, AL 36067
(334) 365-2205
(334) 361-7975
Mailing address
PO DRAWER 681330, PRATTVILLE, AL 36068-1330
(334) 365-2205
(334) 361-7975

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10401
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000030008
AL
01
51030008
BLUE CROSS BLUE SHIELD
AL
Enumeration date
01/29/2007
Last updated
02/21/2020
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