Organization
NORTHSIDE,P.C.
Active
Other names
Northside Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE KRUSE (OFFICE MANAGER)
(251) 675-4733
Entity
Organization
Contact information
Practice address
1020 CLEVELAND RD, SARALAND, AL 36571
(251) 675-4733
(251) 679-9874
Mailing address
1020 CLEVELAND RD, SARALAND, AL 36571
(251) 675-4733
(251) 679-9874
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529101630
—
AL
Enumeration date
12/19/2006
Last updated
05/05/2008
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