Organization
PROFESSIONAL RESOURCE MANAGMENT OF WIREGRASS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY A GILLEY (AUTHORIZED OFFICIAL)
(334) 712-1170
Entity
Organization
Contact information
Practice address
1970 ANDREWS AVE, OZARK, AL 36360-3726
(334) 774-1555
Mailing address
2812 HARTFORD HWY STE 1, DOTHAN, AL 36305-4927
(334) 712-1170
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529923390
—
AL
01
—
K365
MEDICARE GROUP
AL
Enumeration date
11/30/2006
Last updated
12/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up