Organization
INNOVA PRIMARY CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE R UPTAGRAFFT MD (PHYSICIAN)
(256) 882-1510
Entity
Organization
Contact information
Practice address
247 CHATEAU DR SW, HUNTSVILLE, AL 35801-6401
(256) 882-1510
(256) 217-5838
Mailing address
247 CHATEAU DR SW, HUNTSVILLE, AL 35801-6401
(256) 882-1510
(256) 217-5838
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AL
Enumeration date
08/26/2011
Last updated
07/12/2023
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