# BRIDGEPORT FAMILY PRACTICE OBGYN CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mohan & Mohan Medical - West
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255487039
- **Authorized official:** T. MURALI MOHAN M.D. (PARTNER)
- **Authorized official phone:** (256) 437-2431

## Contact information

- **Practice address:** 230 KENTUCKY AVE, STEVENSON, AL 35772-3102
- **Practice address phone:** (256) 437-2431
- **Practice address fax:** (256) 437-8303
- **Mailing address:** PO BOX 920, BRIDGEPORT, AL 35740-0920
- **Mailing address phone:** (256) 437-2431
- **Mailing address fax:** (256) 437-8303

## Taxonomy

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

## Other

- **Enumeration date:** 01/26/2007
- **Last updated:** 08/22/2020