=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124288436
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PALMER PSYCHIATRIC SERVICES,PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/10/2008
-----------------------------------------------------
Last Update Date | 06/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3090 WOODLEY RD SUITE A
-----------------------------------------------------
City | MONTGOMERY
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36116-3100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-280-3230
-----------------------------------------------------
Fax | 334-280-3272
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3090 WOODLEY RD
-----------------------------------------------------
City | MONTGOMERY
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36116-3100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-280-3230
-----------------------------------------------------
Fax | 334-280-3272
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHIATRIST
-----------------------------------------------------
Name | DR. CLEMMIE L PALMER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 334-280-3230
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------