Organization
PRIMARY CARE CTR OF TUSCALOOSA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA K SMELLEY MD (OWNER)
(205) 366-9181
Entity
Organization
Contact information
Practice address
1000 FAIRFAX PARK, TUSCALOOSA, AL 35406-2806
(205) 366-9181
Mailing address
1000 FAIRFAX PARK, TUSCALOOSA, AL 35406-2806
(205) 366-9181
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
21061
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51517558
BLUE CROSS BLUE SHIELD
AL
Enumeration date
02/01/2007
Last updated
07/07/2008
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