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Organization
RUSSELLVILLE PHYSICIAN PRACTICES LLC
Active
Organization
RUSSELLVILLE PHYSICIAN PRACTICES LLC
Active
Other names
Azalea OBGYN
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM M. GRACEY (COO)
(615) 372-8500
Entity
Organization
Contact information
Practice address
523 GANDY ST NE, SUITE F, RUSSELLVILLE, AL 35653-1961
(256) 331-3988
(256) 331-3987
Mailing address
PO BOX 270, RUSSELLVILLE, AL 35653-0270
(256) 331-3988
(256) 331-3987
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
27647
AL
Other
Enumeration date
04/02/2008
Last updated
06/06/2008
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