GMUC OF TILLMANS CORNER (NPI# 1386053783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386053783 |
| Entity Type | Organization |
| Organization Name | GMUC OF TILLMANS CORNER |
| Practice Address |
5100 Rangeline Service Rd N Mobile AL 36619-9504 |
| Practice Telephone | 2516330123 |
| Practice Fax Number | 2514453722 |
| Mailing Telephone | 2516330123 |
| Mailing Fax Number | 2514453722 |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2014-08-11 |
| Authorized Official Name | DARREN WATERS (PARTNER) |
| Authorized Official Telephone | 2516330123 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
5100 RANGELINE SERVICE RD N |
| City | MOBILE |
| State | AL |
| Zip Code | 36619-9504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356394837 | Mark R. Mccutcheon | Family Medicine | 5100 Rangeline Service Rd N, Tillman's Corner, Mobile, AL 36619-9504 | 2006-05-18 |
| 1235145335 | Russell Wayne Stevens | Family Medicine | 5100 Rangeline Service Rd N, Mobile, AL 36619-9504 | 2006-07-31 |
| 1952315343 | Alan Jay Sherman | Family Medicine | 5100 Rangeline Service Rd N, Mobile, AL 36619-9504 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184263816 | Julia Cheryl Tritch | Registered Nurse | 5130 Southbend Drive West, Mobile, AL 36619 | 2019-12-28 |
| 1386058311 | Monica Leigh Postage | Pharmacist | 5245 Rangeline Service Road South, Mobile, AL 36619 | 2014-06-18 |
| 1548604739 | Tillman's Corner Dental, P.C. | Dentist | 5659 Three Notch Rd., Mobile, AL 36619 | 2013-04-18 |
| 1417248410 | Quyen Nguyen | Pharmacist | 5440-a Highway 90 West, Mobile, AL 36619 | 2011-04-25 |
| 1760791909 | Brenetta M. Carraway | Pharmacist | 5451 Halls Mill Road, Suite 14, Mobile, AL 36619 | 2010-10-06 |
| 1881841419 | Virginia Leigh Childress | Physical Therapist | 5320 Us Hwy 90 Service Rd, Mobile, AL 36619 | 2008-08-26 |
| 1952457855 | Infirmary Occupational Health, PC | Preventive Medicine | 5320 Us Hwy 90 West, Mobile, AL 36619 | 2007-01-25 |
| 1417035676 | Leslie G Lovorn | Pharmacist | 5440 U.S. Highway 90 West, Mobile, AL 36619 | 2006-11-02 |
| 1427149947 | Foster Chiropractic Group, PC | Chiropractor | 4400 B Rangeline Rd, Mobile, AL 36619 | 2006-09-28 |
| 1306942628 | Mobile Family Care Center,inc | Family Medicine | 5560 Nevius Road, Mobile, AL 36619 | 2006-09-15 |
| Find all providers in zip 36619 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922624097 | Kyle Rolfe | General Practice | 1962 Schillinger Rd S, Mobile, AL 36695-4118 | 2020-06-24 |
| 1598128167 | James Oliver Walls | General Practice | 213 Glenwood St, Mobile, AL 36606-4438 | 2016-03-31 |
| 1447697743 | Justin L. Ellerman | General Practice | 2451 University Hospital Dr # 400-k, Mobile, AL 36617-2300 | 2013-05-28 |
| 1073891792 | American Family Care, Inc. | General Practice | 5235 Rangeline Service Rd S, Ste# 101, Mobile, AL 36619-9541 | 2011-07-29 |
| 1649451683 | Chykeetra S. Maltbia | General Practice | 5011 Government Blvd Ste B, Mobile, AL 36693-5029 | 2007-11-19 |
| 1598841322 | Jonathan Ross Moore Sr. | General Practice | 75 S Lafayette St, Mobile, AL 36604-1730 | 2006-10-27 |
| 1477505378 | Charles William Bodie | General Practice | 5580 Inn Rd, Suite 200, Mobile, AL 36619 | 2006-05-17 |
| 1013986785 | Franklin Primary Health Center, Inc. | General Practice | 1904 Bishop Ave, Mobile, AL 36610 | 2006-03-16 |
| 1508398942 | Peter Soh | General Practice | 2451 Fillingim St Ste 10-f, Mobile, AL 36617-2238 | 2017-04-03 |
| 1487003653 | Berney Vincent | General Practice | 801 S University Blvd Ste D, Mobile, AL 36609-2949 | 2016-06-08 |
| Find all providers in MOBILE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.