Healthcare Provider Details

I. General information

NPI: 1316978588
Provider Name (Legal Business Name): BHC-PALMER ORTHOPAEDICS AND SPORTS MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MEDICAL PARK
FORT PAYNE AL
35968
US

IV. Provider business mailing address

200 BEACON PKWY W SUITE 330
BIRMINGHAM AL
35209-3102
US

V. Phone/Fax

Practice location:
  • Phone: 256-997-9777
  • Fax: 256-997-9768
Mailing address:
  • Phone: 205-715-5910
  • Fax: 205-715-5928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JOHN E. BOYLE
Title or Position: PRESIDENT
Credential:
Phone: 205-715-5901