Healthcare Provider Details
I. General information
NPI: 1598135220
Provider Name (Legal Business Name): FAMILY PRACTICE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/07/2015
Last Update Date: 10/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
217 DOTHAN RD
ABBEVILLE AL
36310-2836
US
IV. Provider business mailing address
217 DOTHAN RD
ABBEVILLE AL
36310-2836
US
V. Phone/Fax
- Phone: 334-585-6421
- Fax:
- Phone: 334-585-6421
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RICHARD
MEADOWS
Title or Position: PHYSICIAN/OWNER
Credential: DO
Phone: 334-585-6421