| NPI | 1558642017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA JOHNIE SHELBY Executive Director 205-363-5555 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2011-11-22 |