Organization
BREWTON MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR HUNT JR. (ADMINISTRATOR)
(251) 867-6071
Entity
Organization
Contact information
Practice address
1121 BELLEVILLE AVE, BREWTON, AL 36426-1505
(251) 867-6071
(251) 867-5999
Mailing address
PO BOX 648, BREWTON, AL 36427-0648
(251) 867-6071
(251) 867-5999
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000060008
—
AL
01
—
CB0244
MEDICARE/RAILROAD MEDICAR
AL
Enumeration date
05/29/2006
Last updated
07/01/2011
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