# ST. VINCENT'S GARDENDALE CLINIC, LLC

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

## Provider details

- **NPI number:** 1992051379
- **Authorized official:** BRANDON WILLIAMS (CFO)
- **Authorized official phone:** (205) 930-2592

## Contact information

- **Practice address:** 2217 DECATUR HIGHWAY, SUITE 101, GARDENDALE, AL 35071-2301
- **Practice address phone:** (205) 418-1200
- **Practice address fax:** (205) 418-1271
- **Mailing address:** 50 MEDICAL PARK DRIVE EAST, BUILDING 46, SUITE 310, BIRMINGHAM, AL 35235-3401
- **Mailing address phone:** (205) 868-6215
- **Mailing address fax:** (205) 868-6320

## Taxonomy

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

## Other

- **Enumeration date:** 08/03/2012
- **Last updated:** 09/06/2017