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General NPI Number Information
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NPI Number | 1457381261
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Entity Type | Organization
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Legal Business Name | DOCTORS CLINIC OF MONROEVILLE PC
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 75 HIGHWAY 136 W
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City | MONROEVILLE
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State | AL
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Zip | 36460
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Country | US
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Telephone | 251-575-4825
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Fax | 251-575-7730
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Provider Business Mailing Address
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Address Line | 75 HIGHWAY 136 W
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City | MONROEVILLE
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State | AL
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Zip | 36460
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Country | US
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Telephone | 251-575-4825
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Fax | 251-575-4825
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Authorized Official
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Title or Position | SEC.TRES.
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Name | DR. ALBERT R BOROUGHS IV
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Credential | MD
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Telephone | 251-575-4825
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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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