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General NPI Number Information
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NPI Number | 1013191972
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Entity Type | Organization
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Legal Business Name | ST. VINCENT'S BLOUNT
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 150 GILBREATH DR
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City | ONEONTA
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State | AL
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Zip | 35121-2827
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Country | US
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Telephone | 205-274-3001
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Fax | 205-274-3002
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Provider Business Mailing Address
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Address Line | PO BOX 1000
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City | ONEONTA
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State | AL
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Zip | 35121-0013
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Country | US
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Telephone | 205-274-3001
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Fax | 205-274-3002
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Authorized Official
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Title or Position | PRESIDENT/COO
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Name | MR. SEAN CAREY TINNEY
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Credential |
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Telephone | 205-274-3001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H0501
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License Number State | AL
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