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Organization

IVY CREEK OF ELMORE LLC

Active
Other names
IVY CREEK INTERNAL MEDICINE
Organization subpart
No

Provider details

NPI number
Authorized official
LYNDA GAYLE DOZIER-MCCORMICK (BILLING MANAGER)
(334) 514-3848
Entity
Organization

Contact information

Practice address
807 JACKSON TRACE RD, WETUMPKA, AL 36092-1504
(334) 358-3777
Mailing address
807 JACKSON TRACE RD, WETUMPKA, AL 36092-1504

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
07/20/2017
Last updated
03/29/2018
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