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General NPI Number Information
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NPI Number | 1437938685
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Entity Type | Organization
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Legal Business Name | CULLMAN FAMILY MEDICINE
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Dates
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Enumeration Date | 09/27/2023
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 111 4TH AVE NE
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City | CULLMAN
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State | AL
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Zip | 35055-1902
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Country | US
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Telephone | 256-708-2826
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Fax | 256-573-1076
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Provider Business Mailing Address
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Address Line | 4227 OLD BROOK LN
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City | MOUNTAIN BRK
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State | AL
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Zip | 35243-1717
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Country | US
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Telephone | 610-416-6579
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEX SELIGSON
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Credential |
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Telephone | 610-416-6579
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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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