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NPI Code Detail

MEDICARE: WEST LIMESTONE FAMILY CARE LLC

MEDICARE: WEST LIMESTONE FAMILY CARE 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
1207Q00000XFamily Medicine PhysicianDO512AL

General Provider Information

NPI Number : 1760614796
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEST LIMESTONE FAMILY CARE LLC
Provider Business Mailing Address
First Line : PO BOX 1044
Second Line :
City : ATHENS
State : AL
Zip : 35612-1044
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 25678 WEST LIMESTONE SCHOOL ROAD
Second Line :
City : ELKMONT
State : AL
Zip : 35620-7938
Country : US
Telephone Number : 256-777-6805
Fax Number : 256-614-1240
Authorized Official
Title or Position : MANAGING MEMBER
Name : JARROD TAYLOR
Credential :
Telephone Number : 256-777-6805
Provider Enumeration Date : 08/09/2009
Last Update Date : 08/28/2009

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Directions to “WEST LIMESTONE FAMILY CARE LLC ” Practice Location

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