Organization
RUSSELLVILLE HOSPITAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD J. BIVACCA (PRESIDENT)
(615) 920-7000
Entity
Organization
Contact information
Practice address
15155 HIGHWAY 43, RUSSELLVILLE, AL 35653-1975
(256) 332-1611
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-4536
(615) 920-7000
(615) 920-8913
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
02/20/2007
Last updated
07/28/2014
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