Organization
OBELISK HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIONNE WILLIAMS (OFFICE MANAGER)
(334) 558-0262
Entity
Organization
Contact information
Practice address
4705 WOODMERE BLVD, MONTGOMERY, AL 36106-3078
(334) 558-0262
(334) 558-0267
Mailing address
4705 WOODMERE BLVD, MONTGOMERY, AL 36106-3078
(334) 558-0262
(334) 558-0267
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
20243
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-21545
BCBS ALABAMA
AL
05
—
529922860
—
AL
Enumeration date
12/04/2007
Last updated
10/15/2009
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