MEDICARE: MEDAC, PC

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
1	261QP2300X	Primary Care Clinic/Center	16079	AL

General Provider Information

NPI Number	:	1134538572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDAC, PC

Provider Business Mailing Address
First Line	:	PO BOX 680519
Second Line	:
City	:	PRATTVILLE
State	:	AL
Zip	:	36068-0519
Country	:	US
Telephone Number	:	334-361-8555
Fax Number	:	866-923-0406

Provider Business Practice Location Address
First Line	:	270 INTERSTATE COMMERCIAL PARK LOOP
Second Line	:
City	:	PRATTVILLE
State	:	AL
Zip	:	36066-7361
Country	:	US
Telephone Number	:	334-361-8555
Fax Number	:	866-923-0406

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. JOHNNIE WAYNE STRICKLAND JR.
Credential	:	MD
Telephone Number	:	334-361-8555

Provider Enumeration Date	:	08/11/2014
Last Update Date	:	08/11/2014

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