Organization
TROY FAMILY MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHYLECYA YVETTE CHEATHAM MD (PRESIDENT)
(334) 807-0235
Entity
Organization
Contact information
Practice address
101 COUNTRY CLUB RD, TROY, AL 36079-3093
(334) 807-0235
(334) 807-0099
Mailing address
101 COUNTRY CLUB RD, TROY, AL 36079-3093
(334) 807-0235
(334) 807-0099
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00019306
AL
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000044674
—
AL
01
—
01D0961776
CLEA
AL
01
—
51044674
BLUE CROSS PROVIDER #
AL
Enumeration date
01/10/2007
Last updated
01/23/2019
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