Organization
JACKSON FAMILY PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSCAR V, FADUL M.D. (OWNER)
(256) 574-6157
Entity
Organization
Contact information
Practice address
506 HARLEY ST, SCOTTSBORO, AL 35768-4219
(256) 574-6157
(256) 259-0560
Mailing address
PO BOX 56, SCOTTSBORO, AL 35768-0056
(256) 574-6157
(256) 259-0560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.9585
AL
Other
Enumeration date
01/21/2010
Last updated
01/21/2010
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