Organization
LAKELAND PHYSICIAN PRACTICES LLC
Active
Other names
Bankhead General Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD J BIVACCA (PRESIDENT)
(615) 372-8500
Entity
Organization
Contact information
Practice address
42030 HIGHWAY 195, HALEYVILLE, AL 35565-7054
(615) 372-8500
Mailing address
PO BOX 697, HALEYVILLE, AL 35565-0697
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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