Organization
SOUTH DEKALB FAMILY MEDICAL ASSOCIATES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIE MILLER (OFFICE MANAGER)
(256) 505-4532
Entity
Organization
Contact information
Practice address
15239 AL HWY 68 W, CROSSVILLE, AL 35962-0158
(256) 528-7173
(256) 528-2425
Mailing address
15239 AL HIGHWAY 68 W, CROSSVILLE, AL 35962-0158
(256) 528-7173
(256) 528-2425
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
541003854
—
AL
Enumeration date
05/10/2010
Last updated
06/10/2010
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