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General NPI Number Information
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NPI Number | 1851799597
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Entity Type | Organization
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Legal Business Name | BAPTIST MEDICAL CENTER SOUTH OB/GYN GROUP
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Dates
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Enumeration Date | 12/11/2014
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Last Update Date | 12/11/2014
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Provider Practice Location Address
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Address Line | 29 L V STABLER DR STE 4
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City | GREENVILLE
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State | AL
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Zip | 36037-3850
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Country | US
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Telephone | 334-288-3400
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Fax | 334-288-0188
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Provider Business Mailing Address
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Address Line | 2601 WOODLEY PARD DRIVE
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City | MONTGOMERY
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State | AL
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Zip | 36116
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Country | US
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Telephone | 334-288-3400
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Fax | 334-288-0188
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Authorized Official
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Title or Position | CEO
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Name | DR. ROOSEVELT MCCORVEY
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Credential | M.D.
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Telephone | 334-262-0256
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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 |
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License Number State |
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