Healthcare Provider Details

I. General information

NPI: 1639394513
Provider Name (Legal Business Name): RED MOUNTAIN FAMILY MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 BEACON PKWY W STE 860
BIRMINGHAM AL
35209-3118
US

IV. Provider business mailing address

600 BEACON PKWY W STE 860
BIRMINGHAM AL
35209-3118
US

V. Phone/Fax

Practice location:
  • Phone: 205-933-4520
  • Fax: 205-933-4530
Mailing address:
  • Phone: 205-933-4520
  • Fax: 205-933-4530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12403
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BONNIE HOPPER ARMOUR
Title or Position: PRESIDENT
Credential: MD
Phone: 205-933-4520