| NPI | 1134506058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY JOHANSEN President 205-421-2101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208D00000X General Practice | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2023-02-20 |