Provider Demographics
NPI:1255516803
Name:AMERICAN PRIMARY CARE OF PRATTVILLE, PC
Entity type:Organization
Organization Name:AMERICAN PRIMARY CARE OF PRATTVILLE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CARSON
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-491-1901
Mailing Address - Street 1:1807 STATION DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-5664
Mailing Address - Country:US
Mailing Address - Phone:334-491-1901
Mailing Address - Fax:334-491-1903
Practice Address - Street 1:1807 STATION DR
Practice Address - Street 2:SUITE C
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-5664
Practice Address - Country:US
Practice Address - Phone:334-491-1901
Practice Address - Fax:334-491-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25906207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH46562Medicare UPIN