Organization
PRESTIGE TELEMEDICINE GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN BROOKS FAGGARD CRNP (GENERAL MANAGER)
(251) 610-4188
Entity
Organization
Contact information
Practice address
303 CUMBERLAND RD, FAIRHOPE, AL 36532-3442
(251) 517-4411
Mailing address
1008 RANDALL AVE, DAPHNE, AL 36526-4231
(251) 517-4411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/23/2020
Last updated
07/23/2020
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