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General NPI Number Information
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NPI Number | 1932650645
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Entity Type | Organization
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Legal Business Name | ST. VINCENT'S BLOUNT
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Dates
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Enumeration Date | 10/18/2016
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Last Update Date | 09/06/2017
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Provider Practice Location Address
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Address Line | 150 GILBREATH DR SUITE 201
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City | ONEONTA
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State | AL
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Zip | 35121-2827
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Country | US
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Telephone | 205-274-3010
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Fax |
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Provider Business Mailing Address
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Address Line | 50 MEDICAL PARK DR E SUITE 310, FINANCE
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3401
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | BRANDON WILLIAMS
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Credential |
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Telephone | 205-838-3766
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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 |
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License Number State |
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