IVY CREEK MEDICAL ASSOCIATES NPI 1659055184

NPI Information

NPI: 1659055184
Provider Name: IVY CREEK MEDICAL ASSOCIATES
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
73996 TALLASSEE HWY
WETUMPKA, AL
ZIP 36092
Phone: (334) 567-4311
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IVY CREEK MEDICAL ASSOCIATES is a primary care clinic center in Wetumpka, AL. IVY CREEK MEDICAL ASSOCIATES NPI is 1659055184. The provider is registered as an organization entity type.

The provider's business location address is:

73996 TALLASSEE HWY
WETUMPKA, AL
ZIP 36092-310
Phone: (334) 567-4311

The provider's authorized official is Michael D Bruce .
The authorized official title is Ceo and has the following contact phone number (256) 675-0412.

The enumeration date for this NPI number is 6/14/2023 and was last updated on 6/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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