| NPI | 1316559917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HAWTHORNE Billing Manager 205-997-2417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2026-02-09 |