Healthcare Provider Details

I. General information

NPI: 1740439587
Provider Name (Legal Business Name): MARSHALL MEDICAL CENTER NORTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 AL HIGHWAY 69
GUNTERSVILLE AL
35976-7140
US

IV. Provider business mailing address

PO BOX 11407
BIRMINGHAM AL
35246-0100
US

V. Phone/Fax

Practice location:
  • Phone: 256-571-8000
  • Fax:
Mailing address:
  • Phone: 256-894-6701
  • Fax: 256-894-6731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHERYL HAYS
Title or Position: ADMINISTRATOR
Credential:
Phone: 256-571-8008