Organization · Type 2 NPI

Premise Health of Alabama Medical PC

Multi-Specialty Clinic/Center · Prattville, AL

NPI number 1104284405 Active

Practice location

100 Jensen Rd
Prattville, AL 36067-4868

Call (334) 361-5568 Map

Fax (334) 365-5623

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993

Specialties and licenses

Taxonomy	Code	License
Multi-Specialty Clinic/Center Primary	261QM1300X	None listed

Multi-Specialty Clinic/Center: Definition to come...

Other multi-specialty clinic/center providers in Prattville

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First Choice Wellness Centers, LLCMulti-Specialty Clinic/Center Prattville, AL NPI 1982395927

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NPI record

NPI: 1104284405
Entity type: Organization (Type 2)
Issued: Feb 2, 2016
Last updated: Sep 24, 2025
Status: Active

Other names

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Ip Prattville Mill Health Center · doing business as
Ip Prattville Mill Health Center · doing business as

Authorized official

Jon Leizman, MD
President
(216) 479-9063

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104284405

Premise Health of Alabama Medical PC's National Provider Identifier is 1104284405, issued on Feb 2, 2016. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Prattville, AL. The record was last updated on Sep 24, 2025.