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General NPI Number Information
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NPI Number | 1609696079
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Entity Type | Organization
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Legal Business Name | HELEN KELLER SPECIALTY CARE
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 1300 S MONTGOMERY AVE
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City | SHEFFIELD
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State | AL
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Zip | 35660-6334
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Country | US
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Telephone | 256-386-4196
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 21007
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City | HUNTSVILLE
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State | AL
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Zip | 35813-5007
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Country | US
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Telephone | 256-801-6504
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Fax | 256-801-6218
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Authorized Official
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Title or Position | CFO
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Name | CLINTON CARTER
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Credential |
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Telephone | 256-265-8818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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