Organization
SOUTHSIDE MEDICAL SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN FORTSON MD (OWNER/MD)
(205) 753-3462
Entity
Organization
Contact information
Practice address
510 WOLF CREEK RD N, PELL CITY, AL 35125-2477
(205) 753-3462
Mailing address
3413 MOSS BROOK LN, VESTAVIA, AL 35243-4951
(205) 753-3462
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/05/2021
Last updated
01/05/2021
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