Provider Demographics
NPI:1225137763
Name:UNIVERSITY FAMILY PRACTICE, P.C.
Entity Type:Organization
Organization Name:UNIVERSITY FAMILY PRACTICE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-345-6960
Mailing Address - Street 1:904 ANNA AVE
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2014
Mailing Address - Country:US
Mailing Address - Phone:205-345-6960
Mailing Address - Fax:205-345-1147
Practice Address - Street 1:904 ANNA AVE
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2014
Practice Address - Country:US
Practice Address - Phone:205-345-6960
Practice Address - Fax:205-345-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty