Provider Demographics
NPI:1356073886
Name:UAB FAMILY AND COMMUNITY MEDICINE
Entity Type:Organization
Organization Name:UAB FAMILY AND COMMUNITY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:205-704-7800
Mailing Address - Street 1:4749 RED LEAF CIR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-4213
Mailing Address - Country:US
Mailing Address - Phone:205-704-7800
Mailing Address - Fax:
Practice Address - Street 1:501 EMERY DR W
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4625
Practice Address - Country:US
Practice Address - Phone:205-989-7254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty