Organization
WIREGRASS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES P WRIGHT (VP PHYSICIAN BUSINESS SERVICES)
(615) 778-1502
Entity
Organization
Contact information
Practice address
4300 W MAIN ST, SUITE 21, DOTHAN, AL 36305-1054
(334) 794-5000
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7000
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207T00000X
Neurological Surgery Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
363A00000X
Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
06/24/2011
Last updated
01/23/2020
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