Healthcare Provider Details

I. General information

NPI: 1467342642
Provider Name (Legal Business Name): MMC SPECIALTY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 US HIGHWAY 431
BOAZ AL
35957-5908
US

IV. Provider business mailing address

PO BOX 21007
HUNTSVILLE AL
35813-5007
US

V. Phone/Fax

Practice location:
  • Phone: 256-801-6048
  • Fax: 256-801-6218
Mailing address:
  • Phone: 256-801-6048
  • Fax: 256-801-6218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CLINTON CARTER
Title or Position: CFO
Credential:
Phone: 256-265-8818