| NPI | 1366408502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP KELLEY BOBO President/Owner 205-349-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 261QE0002X Clinic/Center, Emergency Care | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QU0200X Clinic/Center, Urgent Care | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336C0002X Pharmacy, Clinic Pharmacy (Licence: AZ ASEP #0133467) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2022-10-18 |