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General NPI Number Information
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NPI Number | 1740567486
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Entity Type | Organization
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Legal Business Name | MELVIN D THORNBURY JR MD PC
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Dates
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Enumeration Date | 11/09/2011
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Last Update Date | 11/09/2011
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Provider Practice Location Address
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Address Line | 2525 US HIGHWAY 431 SUITE 220
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City | BOAZ
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State | AL
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Zip | 35957-5934
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Country | US
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Telephone | 256-840-4520
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Fax | 256-840-4527
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Provider Business Mailing Address
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Address Line | 2525 US HIGHWAY 431 SUITE 220
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City | BOAZ
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State | AL
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Zip | 35957-5967
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Country | US
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Telephone | 256-840-4520
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Fax | 256-840-4527
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Authorized Official
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Title or Position | M.D.
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Name | DR. MELVIN DELAINE THORNBURY JR.
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Credential | M.D.
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Telephone | 256-840-4520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 14828
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License Number State | AL
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