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General NPI Number Information
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NPI Number | 1235373234
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Entity Type | Organization
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Legal Business Name | JOHN CHRISTOPHER BREWER
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Dates
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Enumeration Date | 04/22/2009
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Last Update Date | 04/22/2009
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Provider Practice Location Address
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Address Line | 11491 US HIGHWAY 431 STE. D
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City | ALBERTVILLE
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State | AL
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Zip | 35950-0136
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Country | US
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Telephone | 256-891-5102
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Fax | 256-891-5103
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Provider Business Mailing Address
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Address Line | 1113 OBRIG AVE
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-1421
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Country | US
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Telephone | 256-891-5102
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Fax | 256-891-5103
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Authorized Official
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Title or Position | MANAGER
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Name | STAN HUBBARD
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Credential |
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Telephone | 256-891-5102
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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 | 00021112
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License Number State | AL
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