Provider Demographics
NPI:1053484097
Name:FAMILY MEDICINE ASSOCIATES, PC
Entity Type:Organization
Organization Name:FAMILY MEDICINE ASSOCIATES, PC
Other - Org Name:DBA RIVER OAKS FAMILY MEDICINE AND URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-353-6874
Mailing Address - Street 1:PO BOX 5689
Mailing Address - Street 2:1813 BELTLINE ROAD SW
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-0689
Mailing Address - Country:US
Mailing Address - Phone:256-353-6874
Mailing Address - Fax:
Practice Address - Street 1:1813 BELTLINE RD SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-5506
Practice Address - Country:US
Practice Address - Phone:256-353-6874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALJ994Medicare ID - Type Unspecified
ALDD2010Medicare PIN