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General NPI Number Information
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NPI Number | 1760998223
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Entity Type | Organization
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Legal Business Name | MARSHALL MEDICAL CENTER SOUTH MEDICAL SPECIALISTS OF NORTH ALABAMA
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Dates
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Enumeration Date | 12/20/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 55 ROWE DR STE C
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-7366
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Country | US
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Telephone | 256-571-8810
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Fax | 256-571-8880
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Provider Business Mailing Address
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Address Line | PO BOX 11407 DEPT#8011
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City | BIRMINGHAM
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State | AL
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Zip | 35246-8011
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Country | US
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Telephone | 256-571-8810
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Fax | 256-571-8880
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Authorized Official
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Title or Position | CFO
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Name | KATHY B NELSON
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Credential |
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Telephone | 256-894-6701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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