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General NPI Number Information
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NPI Number | 1699721704
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Entity Type | Organization
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Legal Business Name | ZOE MEDICAL CARE, LLC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 610 AIRPORT RD SW SUITE 204
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City | HUNTSVILLE
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State | AL
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Zip | 35802-4304
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Country | US
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Telephone | 256-489-0489
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Fax | 256-489-0506
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Provider Business Mailing Address
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Address Line | PO BOX 14074
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City | HUNTSVILLE
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State | AL
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Zip | 35815-0074
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Country | US
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Telephone | 256-489-0489
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Fax | 256-489-0506
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Authorized Official
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Title or Position | OWNER
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Name | DR. CLEMENT U OKINEDO
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Credential | M.D.
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Telephone | 256-489-0489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 00023707
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License Number State | AL
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