Healthcare Provider Details

I. General information

NPI: 1316362106
Provider Name (Legal Business Name): PRI MED PHYSICIANS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2014
Last Update Date: 03/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4035 ATLANTA HWY
MONTGOMERY AL
36109-2920
US

IV. Provider business mailing address

100 CAPITOL COMMERCE BLVD SUITE 250
MONTGOMERY AL
36117-4260
US

V. Phone/Fax

Practice location:
  • Phone: 334-323-4000
  • Fax: 334-386-1479
Mailing address:
  • Phone: 334-323-4000
  • Fax: 334-386-1479

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: MR. JOSEPH HERROD
Title or Position: CEO/OWNER
Credential:
Phone: 334-323-4000