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General NPI Number Information
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NPI Number | 1942574587
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Entity Type | Organization
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Legal Business Name | ALLIANCE HEALTH CENTER PHYCIANS
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 5000 HWY 39 N
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City | MERIDIAN
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State | MS
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Zip | 39301-1021
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Country | US
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Telephone | 601-581-9906
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Fax | 601-696-4898
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Provider Business Mailing Address
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Address Line | 5000 HWY 39 N
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City | MERIDIAN
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State | MS
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Zip | 39301-1021
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Country | US
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Telephone | 601-581-9906
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Fax | 601-696-4898
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Authorized Official
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Title or Position | CEO
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Name | WILLIAM PATTERSON
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Credential |
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Telephone | 601-581-9906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 12-308
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License Number State | MS
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