| NPI | 1114053121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT E BOYETT Physician 205-921-5556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL DO654) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 4622) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2016-05-03 |