Organization
BODYLOGICMD OF BIRMINGHAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY A DONOHUE MD (OWNER)
(770) 402-9602
Entity
Organization
Contact information
Practice address
1024 EDENTON ST, BIRMINGHAM, AL 35242-9258
(866) 460-3246
Mailing address
403 JUNIPER MILL TRCE, CANTON, GA 30114-9601
(770) 402-9602
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD17416
AL
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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