Organization
EVERGREEN BREWTON MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS B GRIFFIN (ADMINISTRATOR)
(251) 809-8398
Entity
Organization
Contact information
Practice address
103 ELLIOTT ST, BREWTON, AL 36426-1336
(251) 867-8001
(251) 867-9643
Mailing address
PO BOX 190, BREWTON, AL 36427-0190
(251) 867-8001
(251) 867-9643
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
13720
AL
Other
Enumeration date
06/10/2009
Last updated
07/01/2009
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