Healthcare Provider Details

I. General information

NPI: 1932304292
Provider Name (Legal Business Name): AFTER HOURS CLINIC INC SUMITON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 04/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 BRYAN RD SUITE 140
SUMITON AL
35148-3422
US

IV. Provider business mailing address

1800 BIRMINGHAM AVE
JASPER AL
35501-5461
US

V. Phone/Fax

Practice location:
  • Phone: 205-648-0240
  • Fax: 205-384-4428
Mailing address:
  • Phone: 205-384-4585
  • Fax: 205-384-4428

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. ANTHONY GRAHAM
Title or Position: PRESIDENT
Credential:
Phone: 205-384-4585