Organization
SELF CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARL STANLEY SELF M.D. (OWNER)
(251) 928-8760
Entity
Organization
Contact information
Practice address
306 S GREENO RD, SUITE A, FAIRHOPE, AL 36532-1905
(251) 928-8760
(251) 928-7028
Mailing address
306 S GREENO RD, SUITE A, FAIRHOPE, AL 36532-1905
(251) 928-8760
(251) 928-7028
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6916
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51083390
BLUE CROSS/BLUESHIELD OF ALABAMA
AL
Enumeration date
04/23/2007
Last updated
06/13/2008
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