# AUTAUGA MEDICAL CLINIC LLC

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

## Provider details

- **NPI number:** 1821396482
- **Authorized official:** MR. JAMES G FAULK (CEO)
- **Authorized official phone:** (334) 361-9979

## Contact information

- **Practice address:** 201 S WASHINGTON ST STE A, AUTAUGAVILLE, AL 36003-2535
- **Practice address phone:** (334) 361-9979
- **Practice address fax:** (334) 361-7858
- **Mailing address:** PO BOX 490, AUTAUGAVILLE, AL 36003-0490
- **Mailing address phone:** (334) 361-9979
- **Mailing address fax:** (334) 361-7858

## Taxonomy

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

## Other

- **Enumeration date:** 03/07/2011
- **Last updated:** 04/20/2011