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General NPI Number Information
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NPI Number | 1336800028
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Entity Type | Organization
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Legal Business Name | BSNR LLC. HARTSELLE VALLEY FAMILY MEDICAL CENTER
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Dates
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Enumeration Date | 01/04/2022
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Last Update Date | 02/09/2022
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Provider Practice Location Address
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Address Line | 301 PINE ST NW STE B
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City | HARTSELLE
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State | AL
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Zip | 35640-2339
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Country | US
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Telephone | 256-773-5469
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Fax | 256-773-5425
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Provider Business Mailing Address
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Address Line | 301 PINE ST NW STE B
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City | HARTSELLE
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State | AL
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Zip | 35640-2339
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Country | US
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Telephone | 256-773-5469
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Fax | 256-773-5425
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | DR. BHAVNA GOWDA
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Credential | MD
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Telephone | 256-773-5469
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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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