Organization
IVY CREEK SPECIALTY CARE
Active
Other names
IVY CREEK ANESTHESIA LAKE MARTIN, Ivy Creek ER
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D BRUCE CEO (CEO)
(334) 567-4311
Entity
Organization
Contact information
Practice address
500 HOSPITAL DR, WETUMPKA, AL 36092-1625
(334) 567-4311
(334) 514-3686
Mailing address
PO BOX 130, WETUMPKA, AL 36092-0003
(334) 567-4311
(334) 514-3686
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
Other
Enumeration date
10/05/2020
Last updated
10/09/2020
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