Healthcare Provider Details

I. General information

NPI: 1255364246
Provider Name (Legal Business Name): FAMILY PRACTICE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1704 S FOREST AVE
LUVERNE AL
36049-7306
US

IV. Provider business mailing address

1704 S FOREST AVE
LUVERNE AL
36049-7306
US

V. Phone/Fax

Practice location:
  • Phone: 334-335-3383
  • Fax: 334-335-3078
Mailing address:
  • Phone: 334-335-3383
  • Fax: 334-335-3078

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: CHARLES TOMPKINS
Title or Position: OWNER
Credential: MD
Phone: 334-335-3383