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General NPI Number Information
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NPI Number | 1134538572
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Entity Type | Organization
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Legal Business Name | MEDAC, PC
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 08/11/2014
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Provider Practice Location Address
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Address Line | 270 INTERSTATE COMMERCIAL PARK LOOP
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City | PRATTVILLE
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State | AL
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Zip | 36066-7361
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Country | US
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Telephone | 334-361-8555
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Fax | 866-923-0406
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Provider Business Mailing Address
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Address Line | PO BOX 680519
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City | PRATTVILLE
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State | AL
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Zip | 36068-0519
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Country | US
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Telephone | 334-361-8555
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Fax | 866-923-0406
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. JOHNNIE WAYNE STRICKLAND JR.
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Credential | MD
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Telephone | 334-361-8555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 16079
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License Number State | AL
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