Individual
MRS. ANNA BLACK MEDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2605 GAULT AVE N STE 200, FORT PAYNE, AL 35967-3700
(256) 979-1550
(256) 979-1576
Mailing address
805 SAINT VINCENTS DR STE 100, BIRMINGHAM, AL 35205-1638
(205) 939-3699
(205) 581-7155
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1905
AL
363A00000X
Physician Assistant
Primary
1599
AL
363A00000X
Physician Assistant
—
—
Other
Enumeration date
08/17/2018
Last updated
06/10/2021
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