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Organization

FMC MEDICAL CLINIC - FAYETTE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DANIEL CLAY CONVILLE (CORP DIRECTOR PHYSICIAN SERVICES)
(205) 759-6165
Entity
Organization

Contact information

Practice address
1653 TEMPLE AVE N STE 1, FAYETTE, AL 35555-1314
(205) 932-1112
Mailing address
1653 TEMPLE AVE N STE 1, FAYETTE, AL 35555-1314
(205) 932-1421
(205) 932-1428

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
07/26/2018
Last updated
10/16/2024
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