Healthcare Provider Details

I. General information

NPI: 1295788784
Provider Name (Legal Business Name): ALICEVILLE RURAL HEALTH CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 CARROLLTON RD
ALICEVILLE AL
35442-1823
US

IV. Provider business mailing address

1400 CARROLLTON RD
ALICEVILLE AL
35442-1824
US

V. Phone/Fax

Practice location:
  • Phone: 205-373-6323
  • Fax: 205-373-2544
Mailing address:
  • Phone: 205-373-6323
  • Fax: 205-373-2544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateAL

VIII. Authorized Official

Name: MR. JOHN TUTEN
Title or Position: PRESIDENT
Credential:
Phone: 205-373-6323