Organization
SOUTH ALABAMA MEDICAL CLINIC LLC
Active
Organization
SOUTH ALABAMA MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGOT PETERS (DIRECTOR)
(251) 865-1852
Entity
Organization
Contact information
Practice address
10075 GRAND BAY WILMER RD S, GRAND BAY, AL 36541-5003
(251) 865-1852
(251) 865-1854
Mailing address
10075 GRAND BAY WILMER RD S, GRAND BAY, AL 36541-5003
(251) 865-1852
(251) 865-1854
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2011
Last updated
07/23/2024
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