Organization
DOCTORS MAKING HOME VISITS
Active
Organization
DOCTORS MAKING HOME VISITS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TISHA NICKSON (CEO)
(334) 303-0657
Entity
Organization
Contact information
Practice address
5801 EASTDALE DR, MONTGOMERY, AL 36117-2158
(334) 303-0657
(334) 356-9003
Mailing address
8910 CROSSWIND CIR APT 305, MONTGOMERY, AL 36117-8066
(334) 303-0657
(334) 356-9003
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
305S00000X
AL
Other
Enumeration date
04/27/2015
Last updated
04/27/2015
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