Organization
CULLMAN COUNTY MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANA JOCHUM HICE (DIRECTOR, PHYSICIAN PRACTICES)
(256) 736-5328
Entity
Organization
Contact information
Practice address
1910 CHEROKEE AVE SW, CULLMAN, AL 35055-5502
(256) 739-3500
(256) 736-1093
Mailing address
1910 CHEROKEE AVE. SW, CULLMAN, AL 35055
(256) 739-3500
(256) 775-6119
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
208M00000X
Hospitalist Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529907580
—
AL
Enumeration date
05/27/2005
Last updated
08/04/2008
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