Healthcare Provider Details

I. General information

NPI: 1750434452
Provider Name (Legal Business Name): EAMC THE WOUND TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PEPPERELL PKWY
OPELIKA AL
36801-5452
US

IV. Provider business mailing address

2000 PEPPERELL PKWY
OPELIKA AL
36801-5452
US

V. Phone/Fax

Practice location:
  • Phone: 334-528-2319
  • Fax: 334-528-2320
Mailing address:
  • Phone: 334-528-2319
  • Fax: 334-528-2320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER M CLARK
Title or Position: DIRECTOR - ONCOLOGY SVC & WOUND CTR
Credential:
Phone: 334-528-2309