Healthcare Provider Details

I. General information

NPI: 1497999700
Provider Name (Legal Business Name): NORTHPORT HOSPITAL DCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2009
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2702 HOSPITAL DR SUITE 201
NORTHPORT AL
35476-3397
US

IV. Provider business mailing address

1820 RICE MINE RD N SUITE 200
TUSCALOOSA AL
35406-3281
US

V. Phone/Fax

Practice location:
  • Phone: 205-333-4522
  • Fax:
Mailing address:
  • Phone: 205-333-4655
  • Fax: 205-333-4660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: KERI HINDMAN
Title or Position: PATIENT ACCOUNTS DIRECTOR
Credential:
Phone: 205-759-7378