MEDICARE: NORTH ALABAMA FAMILY MEDICINE & PSYCHOLOGICAL SERVICES, PC

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	207Q00000X	Family Medicine Physician	25605	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1063520278	OTHER		INDIVIDUAL NPI

General Provider Information

NPI Number	:	1376694984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH ALABAMA FAMILY MEDICINE & PSYCHOLOGICAL SERVICES, PC

Provider Business Mailing Address
First Line	:	PO BOX 130
Second Line	:	537 GANDY STREET
City	:	RUSSELLVILLE
State	:	AL
Zip	:	35653-0130
Country	:	US
Telephone Number	:	256-332-9990
Fax Number	:	256-332-9997

Provider Business Practice Location Address
First Line	:	537 GANDY ST NE
Second Line	:
City	:	RUSSELLVILLE
State	:	AL
Zip	:	35653-1965
Country	:	US
Telephone Number	:	256-332-9990
Fax Number	:	256-332-9997

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LAURA M LINDSEY
Credential	:	MD
Telephone Number	:	256-332-9990

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	08/22/2020

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