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General NPI Number Information
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NPI Number | 1639376759
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Entity Type | Organization
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Legal Business Name | DEIRDRE Z JOINER NICHOLS MD LLC
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 105 W DUBLIN DR.
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City | MADISON
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State | AL
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Zip | 35758-1787
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Country | US
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Telephone | 256-772-0606
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 147
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City | MADISON
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State | AL
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Zip | 35758-0147
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Country | US
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Telephone | 256-772-0606
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. DEIRDRE Z JOINER-NICHOLS
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Credential | MD
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Telephone | 257-772-0606
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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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