Organization
IVY CREEK FAMILY CARE OF LAKE MARTIN
Active
Other names
IVY CREEK URGENT CARE
Organization subpart
No
Provider details
NPI number
Authorized official
JADE LANE (CREDENTIALING MANAGER)
(334) 567-4311
Entity
Organization
Contact information
Practice address
5958 HIGHWAY 49 S UNIT K, DADEVILLE, AL 36853-6771
(256) 825-7821
Mailing address
PO BOX 130, WETUMPKA, AL 36092-0003
(334) 514-3821
(334) 514-3686
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/31/2023
Last updated
03/20/2025
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