# PHYSICIAN MEDICAL CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Physicians Medical Center Carraway
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114119567
- **Authorized official:** MRS. JAN DICESARE (CFO)
- **Authorized official phone:** (205) 502-6111

## Contact information

- **Practice address:** 1600 CARRAWAY BLVD, BIRMINGHAM, AL 35234
- **Practice address phone:** (205) 502-5610
- **Practice address fax:** (205) 502-5513
- **Mailing address:** PO BOX 10288, BIRMINGHAM, AL 35202-0288
- **Mailing address phone:** (205) 502-5610
- **Mailing address fax:** (205) 502-5513

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/09/2007
- **Last updated:** 08/09/2007