# SOUTHERN FAMILY MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MARSHALL MEDICAL CENTER SOUTH
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1255609301
- **Legal business name:** MARSHALL MEDICAL CENTER SOUTH
- **Authorized official:** MRS. TRACI STEWART (DIRECTOR)
- **Authorized official phone:** (256) 840-4571

## Contact information

- **Practice address:** 2367 US HIGHWAY 431, BOAZ, AL 35957-5910
- **Practice address phone:** (256) 840-4571
- **Practice address fax:** (256) 840-4534
- **Mailing address:** P.O. BOX 11407, DEPT\# 2069, BIRMINGHAM, AL 35246-2069
- **Mailing address phone:** (256) 840-4571
- **Mailing address fax:** (256) 840-4534

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 30193 | AL | Yes |

## Other

- **Enumeration date:** 12/05/2011
- **Last updated:** 12/05/2011