Organization
HOLIFIELD CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEATHER PATRICK CAMPBELL (OFFICE MANAGER)
(334) 289-2190
Entity
Organization
Contact information
Practice address
1100 S CEDAR AVE, DEMOPOLIS, AL 36732-3310
(334) 289-2190
(334) 289-2195
Mailing address
1100 S CEDAR AVE, DEMOPOLIS, AL 36732-3310
(334) 289-2190
(334) 289-2195
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0308385
ACOG#
AL
01
—
1-045972
AL LICENSE#
AL
01
—
1436
PRESCRIPTIVE#
AL
01
—
7780
AL LICENSE#
AL
05
—
85905-COW
—
AL
Enumeration date
12/18/2006
Last updated
03/07/2023
Update your record
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