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General NPI Number Information
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NPI Number | 1104149442
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Entity Type | Organization
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Legal Business Name | MARSHALL MEDICAL CENTER NORTH
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 03/15/2011
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Provider Practice Location Address
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Address Line | 4500 MAIN ST
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City | GRANT
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State | AL
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Zip | 35747-8303
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Country | US
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Telephone | 256-728-8600
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 11407 DEPT #0132
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City | BIRMINGHAM
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State | AL
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Zip | 35246-0132
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Country | US
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Telephone | 256-728-8600
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Fax | 256-728-8602
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Authorized Official
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Title or Position | CFO
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Name | MS. KATHY B NELSON
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Credential | CPA
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Telephone | 256-894-6600
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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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