Healthcare Provider Details

I. General information

NPI: 1639503055
Provider Name (Legal Business Name): CAREPLUS FAMILY MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2013
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8914 US HIGHWAY 431
ALBERTVILLE AL
35950-0157
US

IV. Provider business mailing address

8914 US HIGHWAY 431
ALBERTVILLE AL
35950-0157
US

V. Phone/Fax

Practice location:
  • Phone: 256-279-7200
  • Fax: 256-279-5757
Mailing address:
  • Phone: 256-279-7200
  • Fax: 256-279-5757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO645
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number22943
License Number StateAL

VIII. Authorized Official

Name: DAWN VAUGHN
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 256-310-4941