Organization
MONTGOMERY BAPTIST OUTREACH SERVICES CORPORATION
Active
Other names
Hospital Physician Services of Central Alabama
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE ELIZABETH BRUTON (CFO)
(334) 273-4258
Entity
Organization
Contact information
Practice address
440 TAYLOR RD, SUITE 3380, MONTGOMERY, AL 36117-3588
(334) 213-6287
(334) 213-6288
Mailing address
440 TAYLOR RD, SUITE 3380, MONTGOMERY, AL 36117-3588
(334) 211-3628
(334) 213-6288
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0113048
UNITED HEALTHCARE
AL
05
—
529932869
—
AL
01
—
CE1792
RAILROAD ROAD MEDICARE
AL
01
—
G478
MEDICARE GROUP PROVIDER
AL
Enumeration date
02/20/2007
Last updated
04/09/2020
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