Healthcare Provider Details
I. General information
NPI: 1770161432
Provider Name (Legal Business Name): OAK STREET HEALTH PHYSICIANS GROUP OF ALABAMA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/01/2021
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1687 CENTER POINT PKWY STE 121
BIRMINGHAM AL
35215-5525
US
IV. Provider business mailing address
PO BOX 746063
ATLANTA GA
30374-6063
US
V. Phone/Fax
- Phone: 205-557-7022
- Fax: 312-929-0373
- Phone: 773-352-1515
- Fax: 312-929-0373
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TERRENCE
MORTON
Title or Position: CMO
Credential: MD
Phone: 704-607-4835