Ivy Creek of Elmore, LLC

NPI #1154642684 in Wetumpka, Alabama

Provider Information

NPI Number: 1154642684
Entity Type: Organization
Organization Name: Ivy Creek of Elmore, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: IVY CREEK OF ELMORE, LLC
Primary Specialty: Surgery
Enumeration Date: Jun 18, 2010
Last Updated: Sep 22, 2010

Practice Location

Address: 500 HOSPITAL DR
Address 2: SUITE B
City: Wetumpka
State: Alabama
ZIP Code: 36092-1625
Phone: (334) 567-4311

Authorized Official

Name: JAMES G FAULK
Title: CEO
Phone: (334) 567-4311

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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Organizations

Provider Name	Specialty	City
Ivy Creek of Elmore LLC	Surgery	Wetumpka	AI Deep Dive

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