Healthcare Provider Details

I. General information

NPI: 1982920641
Provider Name (Legal Business Name): AMY MAKEMSON MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CHATEAU DR SW STE. 210
HUNTSVILLE AL
35801-6436
US

IV. Provider business mailing address

250 CHATEAU DR SW STE. 210
HUNTSVILLE AL
35801-6436
US

V. Phone/Fax

Practice location:
  • Phone: 256-880-4690
  • Fax: 256-880-4691
Mailing address:
  • Phone: 256-880-4690
  • Fax: 256-880-4691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21181
License Number StateAL

VIII. Authorized Official

Name: DR. AMY MAKEMSON
Title or Position: M.D./PRESIDENT
Credential: M.D.
Phone: 256-880-4690