Provider Demographics
NPI:1063476836
Name:PROFESSIONAL MEDICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:PROFESSIONAL MEDICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SENN
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:334-393-3686
Mailing Address - Street 1:101 E BRUNSON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2526
Mailing Address - Country:US
Mailing Address - Phone:334-393-3686
Mailing Address - Fax:334-347-4906
Practice Address - Street 1:101 E BRUNSON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330
Practice Address - Country:US
Practice Address - Phone:334-393-3686
Practice Address - Fax:334-347-4906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty