Organization
SHOALS INFECTIOUS DISEASE CONSULTANTS LLC
Active
Other names
St. Vincent Infectious Disease and Internal Medicine Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN HILAIRE VINCENT MD (OWNER)
(256) 444-4401
Entity
Organization
Contact information
Practice address
22281 US HIGHWAY 72 STE A, ATHENS, AL 35613-2601
(256) 444-4401
(256) 444-4403
Mailing address
PO BOX 1077, FLORENCE, AL 35630
(256) 444-4401
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
180531025
—
207R00000X
Internal Medicine Physician
MD.36985
—
207RI0200X
Infectious Disease Physician
Primary
MD.36985
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219543
—
AL
Enumeration date
08/01/2018
Last updated
08/23/2021
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