Wiregrass Clinic LLC

NPI #1346817772 in Dothan, Alabama

Provider Information

NPI Number: 1346817772
Entity Type: Organization
Organization Name: Wiregrass Clinic LLC
Primary Specialty: Surgery
Enumeration Date: Jun 4, 2021
Last Updated: Sep 14, 2021

Practice Location

Address: 1450 ROSS CLARK CIR STE 4
City: Dothan
State: Alabama
ZIP Code: 36301-4736
Phone: (334) 699-7900

Authorized Official

Name: JENNIFER L JACKSON
Title: SR DIR PROV ENROLLMENT & ONBOARDING
Phone: (615) 465-3334

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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