Healthcare Provider Details

I. General information

NPI: 1770359044
Provider Name (Legal Business Name): CHILTON FAMILY MEDICINE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 HEALTH CENTER DR
CLANTON AL
35045-2344
US

IV. Provider business mailing address

107 HEALTH CENTER DR
CLANTON AL
35045-2344
US

V. Phone/Fax

Practice location:
  • Phone: 205-280-1010
  • Fax:
Mailing address:
  • Phone: 205-280-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JEFFREY F PRICE
Title or Position: OWNER/MEMBER
Credential:
Phone: 205-280-1010