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Organization
BLUE BAYOU INC
Active
Organization
BLUE BAYOU INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY MORMAN (CEO)
(256) 341-7100
Entity
Organization
Contact information
Practice address
2100 SOUTHBRIDGE PKWY, BIRMINGHAM, AL 35209-1302
(256) 341-7100
Mailing address
2100 SOUTHBRIDGE PKWY, BIRMINGHAM, AL 35209-1302
(256) 341-7100
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
1478
AL
Other
Enumeration date
08/15/2012
Last updated
09/18/2012
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