Ivy Creek of Elmore LLC

NPI #1467975581 in Wetumpka, Alabama

Provider Information

NPI Number: 1467975581
Entity Type: Organization
Organization Name: Ivy Creek of Elmore LLC
Primary Specialty: Internal Medicine
Enumeration Date: Jul 20, 2017
Last Updated: Mar 29, 2018

Practice Location

Address: 807 JACKSON TRACE RD
City: Wetumpka
State: Alabama
ZIP Code: 36092-1504
Phone: (334) 358-3777

Authorized Official

Name: LYNDA GAYLE DOZIER-MCCORMICK
Title: BILLING MANAGER
Phone: (334) 514-3848

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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