Healthcare Provider Details
I. General information
NPI: 1427568336
Provider Name (Legal Business Name): WEST POINT FAMILY MEDICAL PRACTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/05/2017
Last Update Date: 10/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
40131 COUNTY ROAD 1141
VINEMONT AL
35179
US
IV. Provider business mailing address
380 COUNTY ROAD 1200
VINEMONT AL
35179-4601
US
V. Phone/Fax
- Phone: 256-531-4987
- Fax:
- Phone: 256-531-4987
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PATRICIA
D
WILHITE
Title or Position: OWNER
Credential: CRNP
Phone: 256-531-4987