Healthcare Provider Details

I. General information

NPI: 1508308198
Provider Name (Legal Business Name): STV PRIMARY CARE SPRINGVILLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2016
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 WALKER DR
SPRINGVILLE AL
35146-3250
US

IV. Provider business mailing address

70 PLAZA DR
PELL CITY AL
35125-9314
US

V. Phone/Fax

Practice location:
  • Phone: 205-467-6919
  • Fax: 205-467-7088
Mailing address:
  • Phone: 205-814-9284
  • Fax: 205-814-9626

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: RONALD W HELMS JR.
Title or Position: MD
Credential:
Phone: 205-814-9284