MEDICARE: NORTH ALABAMA PHYSICIANS SERVICE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1205124120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH ALABAMA PHYSICIANS SERVICE, LLC

Provider Business Mailing Address
First Line	:	1100 S JACKSON HWY
Second Line	:	SUITE 150
City	:	SHEFFIELD
State	:	AL
Zip	:	35660-5774
Country	:	US
Telephone Number	:	256-386-4680
Fax Number	:	256-386-4682

Provider Business Practice Location Address
First Line	:	1100 S JACKSON HWY
Second Line	:	SUITE 150
City	:	SHEFFIELD
State	:	AL
Zip	:	35660-5774
Country	:	US
Telephone Number	:	256-386-4680
Fax Number	:	256-386-4682

Authorized Official
Title or Position	:	MEMBER / OWNER
Name	:	JACK MCLENDON
Credential	:	M.D.
Telephone Number	:	256-386-4680

Provider Enumeration Date	:	07/12/2011
Last Update Date	:	12/30/2011

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