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Organization
MEDCENTER FAYETTE, LLC
Active
Organization
MEDCENTER FAYETTE, LLC
Active
Parent organization
TUSCALOOSA MEDCENTER NORTH, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TUSCALOOSA MEDCENTER NORTH, PC
Authorized official
BETH KOHN (CREDENTIALING SPECIALIST)
(912) 756-2273
Entity
Organization
Contact information
Practice address
122 17TH CT NE, FAYETTE, AL 35555-1353
(205) 330-1707
(205) 333-0782
Mailing address
3909 MCFARLAND BLVD, NORTHPORT, AL 35476-2838
(205) 330-1707
(205) 333-0782
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/08/2016
Last updated
12/19/2024
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