Healthcare Provider Details

I. General information

NPI: 1871992834
Provider Name (Legal Business Name): FOCUSAL1010
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2014
Last Update Date: 08/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3165 DAUPHIN ST
MOBILE AL
36606-4061
US

IV. Provider business mailing address

PO BOX 360127
BIRMINGHAM AL
35236-0127
US

V. Phone/Fax

Practice location:
  • Phone: 251-378-8635
  • Fax: 251-378-8636
Mailing address:
  • Phone: 877-225-3542
  • Fax: 877-638-9903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD FUHLER
Title or Position: OWNER
Credential: MD
Phone: 251-378-8635