Organization
FMC MEDICAL CLINIC MILLPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN CAMPBELL (DIRECTOR OF PHYSICIAN SERVICE)
(205) 759-6165
Entity
Organization
Contact information
Practice address
13530 HIGHWAY 96, MILLPORT, AL 35576-2522
(205) 662-3207
(205) 333-4660
Mailing address
1820 RICE MINE RD N, SUITE 200, TUSCALOOSA, AL 35406-3281
(205) 333-4661
(205) 333-4660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183355
—
AL
Enumeration date
02/17/2016
Last updated
06/08/2016
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