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General NPI Number Information
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NPI Number | 1588178735
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Entity Type | Organization
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Legal Business Name | MEDICAL CARE ASSOCIATES PRATTVILLE
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Dates
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Enumeration Date | 11/27/2017
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 102 MEDICAL CENTER DR STE A
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City | PRATTVILLE
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State | AL
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Zip | 36066-7286
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Country | US
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Telephone | 205-253-2205
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Fax |
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Provider Business Mailing Address
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Address Line | 2641 OAKLEAF CIR
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City | HELENA
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State | AL
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Zip | 35022-7230
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DERRICK BROWN
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Credential |
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Telephone | 334-361-7404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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