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General NPI Number Information
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NPI Number | 1598621948
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Entity Type | Organization
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Legal Business Name | MMC PRIMARY CARE
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 2505 US HIGHWAY 431
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City | BOAZ
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State | AL
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Zip | 35957-5908
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Country | US
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Telephone | 256-593-8310
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Fax | 256-801-6219
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Provider Business Mailing Address
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Address Line | PO BOX 21007
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City | HUNTSVILLE
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State | AL
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Zip | 35813-5007
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Country | US
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Telephone | 256-801-6048
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Fax | 256-801-6221
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Authorized Official
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Title or Position | CFO
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Name | CLINTON CARTER
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Credential |
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Telephone | 256-265-8818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice 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 | 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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