# RUSSELLVILLE PHYSICIAN PRACTICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Azalea OBGYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649442369
- **Authorized official:** WILLIAM M. GRACEY (COO)
- **Authorized official phone:** (615) 372-8500

## Contact information

- **Practice address:** 523 GANDY ST NE, SUITE F, RUSSELLVILLE, AL 35653-1961
- **Practice address phone:** (256) 331-3988
- **Practice address fax:** (256) 331-3987
- **Mailing address:** PO BOX 270, RUSSELLVILLE, AL 35653-0270
- **Mailing address phone:** (256) 331-3988
- **Mailing address fax:** (256) 331-3987

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 27647 | AL | Yes |

## Other

- **Enumeration date:** 04/02/2008
- **Last updated:** 06/06/2008