Organization
BROOKWOOD PRIMARY CARE- GRAND RIVER, L.L.C.
Active
Other names
Brookwood Primary Care- Grand River, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL KYLE BURTNETT (SVP, OUTPATIENT SERVICES, TENET)
(469) 893-2902
Entity
Organization
Contact information
Practice address
1115 PAYTON WAY., SUITE 111, LEEDS, AL 35094
(205) 352-1175
Mailing address
4902 VALLEYDALE RD, BIRMINGHAM, AL 35242-4613
(205) 980-8099
(205) 980-2606
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
07/06/2015
Last updated
05/26/2016
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