=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083326268
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OAKS FAMILY HEALTHCARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2022
-----------------------------------------------------
Last Update Date | 07/05/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2298 E UNIVERSITY DR STE A-301A
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36830-3538
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-991-5951
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2101 HIGHLAND AVE S STE 350
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35205-4009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-991-5951
-----------------------------------------------------
Fax | 205-558-2559
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN OWNER
-----------------------------------------------------
Name | DR. KIMBERLY F. OWENS
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 334-991-5951
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------