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Organization
FMC MEDICAL CLINIC - FAYETTE LLC
Active
Organization
FMC MEDICAL CLINIC - FAYETTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL CLAY CONVILLE (CORP DIRECTOR PHYSICIAN SERVICES)
(205) 759-6165
Entity
Organization
Contact information
Practice address
1653 TEMPLE AVE N STE 1, FAYETTE, AL 35555-1314
(205) 932-1112
Mailing address
1653 TEMPLE AVE N STE 1, FAYETTE, AL 35555-1314
(205) 932-1421
(205) 932-1428
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/26/2018
Last updated
10/16/2024
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