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General NPI Number Information
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NPI Number | 1508106592
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Entity Type | Organization
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Legal Business Name | IMMEDIATE CARE FOLEY LLC
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 1265 S MCKENZIE ST
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City | FOLEY
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State | AL
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Zip | 36535-1818
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Country | US
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Telephone | 251-300-2785
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Fax | 251-300-2771
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Provider Business Mailing Address
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Address Line | PO BOX 91747
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City | MOBILE
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State | AL
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Zip | 36691-1747
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Country | US
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Telephone | 251-300-2785
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Fax | 251-300-2771
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. BARRY PORTER
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Credential |
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Telephone | 251-300-2785
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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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