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General NPI Number Information
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NPI Number | 1154008480
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Entity Type | Organization
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Legal Business Name | ALBERTVILLE FAMILY MEDICINE LLC
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Dates
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Enumeration Date | 06/29/2023
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 201 W MAIN ST
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City | ALBERTVILLE
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State | AL
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Zip | 35950-1627
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Country | US
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Telephone | 256-929-9074
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Fax |
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Provider Business Mailing Address
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Address Line | 201 W MAIN ST
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City | ALBERTVILLE
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State | AL
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Zip | 35950-1627
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Country | US
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Telephone | 256-251-2012
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Fax | 256-251-2301
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Authorized Official
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Title or Position | COO
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Name | MR. ERIC ROBERT HAGOOD
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Credential | CRNP
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Telephone | 256-251-2012
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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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