# CULLMAN PRIMARY CARE, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CULLMAN PRIMARY CARE, PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164743068
- **Legal business name:** CULLMAN PRIMARY CARE, PC
- **Authorized official:** MRS. CONNIE BLANKENSHIP (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (256) 739-0801

## Contact information

- **Practice address:** 1800 AL HIGHWAY 157 STE 100, CULLMAN, AL 35058
- **Practice address phone:** (256) 739-4131
- **Practice address fax:** (256) 739-6027
- **Mailing address:** 503 CLARK ST NE, CULLMAN, AL 35055-1921
- **Mailing address phone:** (256) 739-0801
- **Mailing address fax:** (256) 739-0027

## Taxonomy

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

## Other

- **Enumeration date:** 06/15/2010
- **Last updated:** 06/15/2023