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General NPI Number Information
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NPI Number | 1023143484
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Entity Type | Organization
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Legal Business Name | BHC-BLOUNT & ETOWAH COUNTIES
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 04/03/2009
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Provider Practice Location Address
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Address Line | 180 MEDICAL STREET
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City | SNEAD
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State | AL
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Zip | 35952
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Country | US
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Telephone | 205-466-7114
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Fax | 205-466-3350
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Provider Business Mailing Address
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Address Line | PO BOX 13128
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City | BIRMINGHAM
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State | AL
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Zip | 35202-3128
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Country | US
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Telephone | 205-715-5904
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Fax | 205-715-5928
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Authorized Official
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Title or Position | CHIEF INTEGRATION OFFICER
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Name | GEORGE SCOTT FENN
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Credential |
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Telephone | 205-715-5415
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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 |
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License Number State |
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