# CLOVERDALE ROAD FAMILY MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265705065
- **Authorized official:** CAROLYN LEONARD (CONTROLLER)
- **Authorized official phone:** (256) 386-4673

## Contact information

- **Practice address:** 3502 CLOVERDALE RD, FLORENCE, AL 35633-1302
- **Practice address phone:** (256) 764-1263
- **Practice address fax:** (256) 764-9611
- **Mailing address:** PO BOX 895, SHEFFIELD, AL 35660-0895
- **Mailing address phone:** (256) 764-1263
- **Mailing address fax:** (256) 764-9611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 8871 | AL | Yes |

## Other

- **Enumeration date:** 02/10/2012
- **Last updated:** 02/10/2012