Healthcare Provider Details

I. General information

NPI: 1740375732
Provider Name (Legal Business Name): HENAGAR FAMILY MEDICINE, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18324 ALABAMA HIGHWAY 75
HENAGAR AL
35978
US

IV. Provider business mailing address

P.O. BOX 518
HENAGAR AL
35978
US

V. Phone/Fax

Practice location:
  • Phone: 256-657-1101
  • Fax: 256-657-1115
Mailing address:
  • Phone: 256-657-1101
  • Fax: 256-657-1115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY SIMS
Title or Position: OWNER
Credential: M.D.
Phone: 256-657-1101