Healthcare Provider Details

I. General information

NPI: 1083774871
Provider Name (Legal Business Name): MOUNTAIN VIEW FAMILY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 01/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5995 HWY 72 EAST
GURLEY AL
35748-0127
US

IV. Provider business mailing address

PO BOX 127
GURLEY AL
35748-0127
US

V. Phone/Fax

Practice location:
  • Phone: 256-776-2094
  • Fax: 256-776-0047
Mailing address:
  • Phone: 256-776-2094
  • Fax: 256-776-0047

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: HEATHER MASON
Title or Position: DIRECTOR OF PHYSICIANS NETWORK
Credential:
Phone: 256-265-7791