# SHOALS INFECTIOUS DISEASE CONSULTANTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St. Vincent Infectious Disease and Internal Medicine Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083192173
- **Authorized official:** JEAN HILAIRE VINCENT MD (OWNER)
- **Authorized official phone:** (256) 444-4401

## Contact information

- **Practice address:** 22281 US HIGHWAY 72 STE A, ATHENS, AL 35613-2601
- **Practice address phone:** (256) 444-4401
- **Practice address fax:** (256) 444-4403
- **Mailing address:** PO BOX 1077, FLORENCE, AL 35630
- **Mailing address phone:** (256) 444-4401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WW0000X | Wound Care Registered Nurse | 180531025 | NULL | — |
| 163WW0000X | Wound Care Registered Nurse | 180531025 | — | — |
| 207R00000X | Internal Medicine Physician | MD.36985 | NULL | — |
| 207R00000X | Internal Medicine Physician | MD.36985 | — | — |
| 207RI0200X | Infectious Disease Physician | MD.36985 | NULL | Yes |
| 207RI0200X | Infectious Disease Physician | MD.36985 | — | Yes |

## Other

- **Enumeration date:** 08/01/2018
- **Last updated:** 08/23/2021