Organization
JERRY DILLARD MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY DEAN DILLARD M.D. (OWNER)
(334) 875-7406
Entity
Organization
Contact information
Practice address
206 W DALLAS AVE, SELMA, AL 36701-6531
(334) 875-7406
Mailing address
206 W DALLAS AVE, SELMA, AL 36701-6531
(334) 875-7406
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
ACSC3813
AL
Other
Enumeration date
01/31/2016
Last updated
01/31/2016
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