Organization
EASTSIDE FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEBRINA B HOLT (EXECUTIVE DIRECTOR)
(256) 216-9648
Entity
Organization
Contact information
Practice address
22289 MEDICAL VILLAGE DR, ATHENS, AL 35613-2896
(256) 232-1414
Mailing address
22289 MEDICAL VILLAGE DR, ATHENS, AL 35613-2896
(256) 232-1414
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/09/2016
Last updated
01/05/2024
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