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General NPI Number Information
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NPI Number | 1639323744
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Entity Type | Organization
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Legal Business Name | EAST ALABAMA CAMPUS HEALTH, LLC
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Dates
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Enumeration Date | 11/17/2008
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Last Update Date | 11/17/2008
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Provider Practice Location Address
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Address Line | 400 LEM MORRISON DRIVE
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City | AUBURN
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State | AL
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Zip | 36849-5349
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Country | US
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Telephone | 205-844-4416
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Fax |
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Provider Business Mailing Address
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Address Line | 400 LEM MORRISON DRIVE
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City | AUBURN
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State | AL
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Zip | 36849-5349
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Country | US
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Telephone | 205-844-4416
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. VICKIE GUNN
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Credential |
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Telephone | 334-844-6175
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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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