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General NPI Number Information
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NPI Number | 1619760162
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Entity Type | Organization
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Legal Business Name | DRUID CITY PHYSICIAN SERVICES, LLC
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 701 UNIVERSITY BLVD E STE 400
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City | TUSCALOOSA
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State | AL
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Zip | 35401-7428
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Country | US
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Telephone | 205-752-0694
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Fax | 205-752-6244
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Provider Business Mailing Address
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Address Line | 701 UNIVERSITY BLVD E STE 400
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City | TUSCALOOSA
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State | AL
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Zip | 35401-7428
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Country | US
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Telephone | 205-752-0694
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Fax | 205-752-6244
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Authorized Official
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Title or Position | VICE PRESIDENT, PHYSICIAN SERVICES
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Name | DANIEL CLAY CONVILLE
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Credential |
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Telephone | 205-759-6165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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