Individual
DR. JOE MACK BANKHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DR
Contact information
Practice address
7199 BEAVER CREEK RD, SULLIGENT, AL 35586-4603
(205) 698-0553
Mailing address
7199 BEAVER CREEK RD, SULLIGENT, AL 35586-4603
(205) 698-0553
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
20283
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20283
—
AL
Enumeration date
11/26/2018
Last updated
11/26/2018
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