Provider Demographics
NPI:1205021623
Name:CUMBERLAND FAMILY CLINIC, INC
Entity Type:Organization
Organization Name:CUMBERLAND FAMILY CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT/SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-259-1413
Mailing Address - Street 1:304 PARKS AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-2412
Mailing Address - Country:US
Mailing Address - Phone:256-259-4218
Mailing Address - Fax:256-259-2589
Practice Address - Street 1:304 PARKS AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-2412
Practice Address - Country:US
Practice Address - Phone:256-259-4218
Practice Address - Fax:256-259-2589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty