Unknown Individual – Family Medicine Physician, NPI 1114920188
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Box Turtle, Grogan's Mill, The Woodlands, Montgomery County, Texas, United States of America
MONTGOMERY, AL 361231396
Phone: (334) 213-8804
Fax: (334) 213-8815
Type: Mailing
Sherwood Drive, Windsor West, Iowa City, Johnson County, Iowa, 52245, United States of America
JOHNSON CITY, TN 37601
Phone: (334) 213-8804
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 36123)
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