Organization
TANNER PRIMARY CARE OF WEDOWEE INC
Active
Organization
TANNER PRIMARY CARE OF WEDOWEE INC
Active
Other names
Wedowee Rural Health
Organization subpart
No
Provider details
NPI number
Authorized official
CLINT HOFFMAN (SR VP)
(770) 812-8845
Entity
Organization
Contact information
Practice address
1030 MAIN ST S, WEDOWEE, AL 36278-7440
(256) 357-2188
(256) 357-2023
Mailing address
100 GREENWAY BLVD FL 2, CARROLLTON, GA 30117-4338
(770) 838-8710
(770) 812-5735
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-8904
RHC CERTIFICATION NUMBER
AL
05
—
139022
—
AL
05
—
155218
—
AL
Enumeration date
04/12/2012
Last updated
02/29/2024
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