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NPI Code Detail

MEDICARE: CLEMMIE PALMER III M.D.

MEDICARE: CLEMMIE PALMER III M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician20071AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
120071OTHERALMEDICAL LICENSE
251099544OTHERALFED BCBS
3274116OTHERALVALUE OPTIONS/UPS SOLUTIONS
451077444OTHERALBCBS OF ALABAMA
500150005325OTHERUNITED HEALTHCARE
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043211758
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLEMMIE PALMER III M.D.
Provider Business Mailing Address
First Line : PO BOX 252026
Second Line :
City : MONTGOMERY
State : AL
Zip : 36125-2026
Country : US
Telephone Number : 334-280-3230
Fax Number : 334-280-3272
Provider Business Practice Location Address
First Line : 3090 WOODLEY RD STE A
Second Line :
City : MONTGOMERY
State : AL
Zip : 36116-3190
Country : US
Telephone Number : 334-280-3230
Fax Number : 334-280-3272
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 06/25/2025

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