Organization
MIZELL MEMORIAL HOSPITAL, INC.
Active
Other names
Mizell Medical Clinic 2
Organization subpart
No
Provider details
NPI number
Authorized official
JANA WYATT (CEO / CFO)
(334) 493-9111
Entity
Organization
Contact information
Practice address
103 E MEMORIAL AVE STE A, OPP, AL 36467-1746
(334) 493-5555
(334) 493-0517
Mailing address
PO BOX 1010, OPP, AL 36467-1010
(334) 493-3541
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
12/24/2019
Last updated
01/14/2021
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