Organization
PIEDMONT FAMILY PRACTICE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL DEAN ULRICH D.O. (PRESIDENT)
(256) 447-9045
Entity
Organization
Contact information
Practice address
25 ROUNDTREE DR, PIEDMONT, AL 36272-5893
(256) 447-9045
(256) 447-9040
Mailing address
PO BOX 450, PIEDMONT, AL 36272-0450
(256) 447-9045
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
DO-47
AL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528602460
—
AL
Enumeration date
01/02/2007
Last updated
01/28/2021
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