Organization
HUNTSVILLE BREAST CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VALERIE M JOHNSON MD (PHYSICIAN OWNER)
(256) 880-8070
Entity
Organization
Contact information
Practice address
4030 BALMORAL DR SW, HUNTSVILLE, AL 35801-6402
(256) 880-8070
(256) 883-3060
Mailing address
4030 BALMORAL DR SW, HUNTSVILLE, AL 35801-6402
(256) 880-8070
(256) 883-3060
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4523
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51089025
BLUE CROSS BLUE SHIELD AL
AL
05
—
529102100
—
AL
Enumeration date
04/13/2007
Last updated
10/25/2010
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