Organization
AFFINITY PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L JACKSON (SR DIR PROV ENROLL & ONBOARDING)
(615) 465-3334
Entity
Organization
Contact information
Practice address
3686 GRANDVIEW PKWY STE 820, BIRMINGHAM, AL 35243-3408
(205) 971-3000
(205) 971-4910
Mailing address
3690 GRANDVIEW PKWY, BIRMINGHAM, AL 35243-3326
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529928290
—
AL
Enumeration date
06/14/2006
Last updated
01/12/2023
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