Organization
FORT PAYNE URGENT CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIZ JUAN APN (OWNER)
(256) 979-1990
Entity
Organization
Contact information
Practice address
2605 GAULT AVE N STE 200, FORT PAYNE, AL 35967-3700
(256) 979-1990
(356) 979-1992
Mailing address
100 FOREST AVE NW, FORT PAYNE, AL 35967-2054
(256) 979-1990
(256) 979-1992
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/06/2022
Last updated
10/16/2024
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