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SOUTHERN DIVINE FAMILY MEDICAL CENTER LLC NPI 1104456920


NPI Information

NPI: 1104456920
Provider Name: SOUTHERN DIVINE FAMILY MEDICAL CENTER LLC

Doing Business As: UNITED DOCTORS FAMILY MEDICAL CENTER - ALTOONA

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 01D2167843

Address:
7130 6TH AVE
ALTOONA, AL
ZIP 35952
Phone: (205) 589-1092
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SOUTHERN DIVINE FAMILY MEDICAL CENTER LLC is an internal medicine in Altoona, AL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. SOUTHERN DIVINE FAMILY MEDICAL CENTER LLC NPI is 1104456920. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As United Doctors Family Medical Center - Altoona.

The provider's business location address is:

7130 6TH AVE
ALTOONA, AL
ZIP 35952-052
Phone: (205) 589-1092
Fax: (205) 589-1096

The provider's authorized official is Michelle Hawthorne .
The authorized official title is Credentialing Coordinator and has the following contact phone number (205) 292-2428.

The CLIA number assigned to this NPI record is 01D2167843 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/21/2020 and was last updated on 9/16/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LA2100XNurse PractitionerAcute CareNo
2363LA2200XNurse PractitionerAdult HealthNo
3363LF0000XNurse PractitionerFamilyNo
4207R00000XInternal MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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