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NPI Code Detail

MEDICARE: MARY SUE SUGGS

MEDICARE: MARY SUE SUGGS
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
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447246053
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARY SUE SUGGS
Provider Business Mailing Address
First Line : 1508 COGSWELL AVE
Second Line :
City : PELL CITY
State : AL
Zip : 35125-1243
Country : US
Telephone Number : 205-814-1598
Fax Number : 205-814-1587
Provider Business Practice Location Address
First Line : 1508 COGSWELL AVE
Second Line :
City : PELL CITY
State : AL
Zip : 35125-1243
Country : US
Telephone Number : 205-814-1598
Fax Number : 205-814-1587
Authorized Official
Title or Position : OWNER
Name : MARY SUE SUGGS
Credential : CRNP
Telephone Number : 205-814-1598
Provider Enumeration Date : 09/20/2005
Last Update Date : 01/28/2010

Similar Medicare Providers

1154317758 — MARY SUE SUGGS
Practice Location Address:
1508 COGSWELL AVE
PELL CITY, AL
35125-1243
Practice Phone: 205-814-1598
Practice Fax: 205-814-1587
1861472219 — JANA GAIL ZEITVOGEL CRNP
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1205854544 — LINDA J SCHULTZ MD
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35125-1243
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1306145289 — MAIN STREET MEDICAL CLINIC LLC
Practice Location Address:
1508 COGSWELL AVE
PELL CITY, AL
35125-1243
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Practice Fax: 205-814-1587
1003242678 — MS. LAURA PAIGE FARRIS CRNP
Practice Location Address:
1508 COGSWELL AVE
PELL CITY, AL
35125-1243
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Practice Fax:
1740895291 — MAIN STREET CLINIC, LLC
Practice Location Address:
1508 COGSWELL AVE
PELL CITY, AL
35125-1243
Practice Phone: 256-418-4300
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Directions to “MARY SUE SUGGS ” Practice Location

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