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General NPI Number Information
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NPI Number | 1699033704
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Entity Type | Organization
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Legal Business Name | JOHN C. BALCAREK MD HEALTH SERVICES LLC
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 01/13/2015
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Provider Practice Location Address
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Address Line | 600 ST. CLAIR BUILDING 1, SUITE 2
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City | HUNTSVILLE
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State | AL
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Zip | 35801
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Country | US
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Telephone | 256-704-7325
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Fax | 256-270-8674
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Provider Business Mailing Address
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Address Line | 600 ST CLAIR BUILDING 1, SUITE 2
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City | HUNTSVILLE
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State | AL
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Zip | 35801
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Country | US
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Telephone | 256-704-7325
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Fax | 256-270-8674
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN C BALCAREK
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Credential | M.D
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Telephone | 256-704-7325
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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 | 24129
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License Number State | AL
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