# FMC MEDICAL CLINIC - BERRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Berry Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588376800
- **Authorized official:** MR. DANIEL CLAY CONVILLE (CORP DIRECTOR, PHYSICIAN SERVICES)
- **Authorized official phone:** (205) 759-6165

## Contact information

- **Practice address:** 32 SCHOOL AVE, BERRY, AL 35546-2246
- **Practice address phone:** (205) 689-0909
- **Mailing address:** 3901 GREENSBORO AVE STE A, TUSCALOOSA, AL 35405-3771
- **Mailing address phone:** (205) 759-6165

## Taxonomy

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

## Other

- **Enumeration date:** 12/19/2022
- **Last updated:** 12/19/2022