Provider Demographics
NPI:1649667577
Name:WILMER MEDICAL CLINIC, LLC
Entity type:Organization
Organization Name:WILMER MEDICAL CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:S
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:251-865-1852
Mailing Address - Street 1:10075 GRAND BAY WILMER RD S
Mailing Address - Street 2:
Mailing Address - City:GRAND BAY
Mailing Address - State:AL
Mailing Address - Zip Code:36541-5003
Mailing Address - Country:US
Mailing Address - Phone:251-865-1852
Mailing Address - Fax:
Practice Address - Street 1:6353 2ND STREET
Practice Address - Street 2:
Practice Address - City:WILMER
Practice Address - State:AL
Practice Address - Zip Code:36587
Practice Address - Country:US
Practice Address - Phone:251-865-1852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty