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Specialty details in registry · Phenix, AL

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At a glance

1114Th 16Th Court South, Phenix, AL 36869

NPPES record updated Jun 6, 2008. Public records can lag behind changes at a practice.

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Practice location

1114Th 16Th Court South
Phenix, AL 36869

Professional details: NPI, taxonomy & registry record

NPI1760641500

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 251K00000X
Enumeration date: Jun 6, 2008
Record updated: Jun 6, 2008

More registry details

Provider type: Organization · Type 2
Other reported name: <UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

251K00000X · Primary

License reported: 120927 CA

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1114Th 16Th Court South
Phenix, AL 36869

Phone: (706) 577-2986

Mailing address

1114TH 16TH COURT SOUTH

PHENIX, AL 36869

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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