Provider Demographics
NPI:1376836817
Name:MEDICAL WEST HUEYTOWN HEALTH CENTER
Entity Type:Organization
Organization Name:MEDICAL WEST HUEYTOWN HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOCUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-481-7134
Mailing Address - Street 1:3004 ALLISON BONNETT MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:HUEYTOWN
Mailing Address - State:AL
Mailing Address - Zip Code:35023-2317
Mailing Address - Country:US
Mailing Address - Phone:205-491-3299
Mailing Address - Fax:205-744-8751
Practice Address - Street 1:3004 ALLISON BONNETT MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HUEYTOWN
Practice Address - State:AL
Practice Address - Zip Code:35023-2317
Practice Address - Country:US
Practice Address - Phone:205-491-3299
Practice Address - Fax:205-744-8751
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HEALTH CARE AUTHORITY FOR MEDICAL WEST, AN AFFILIATE OF UAB HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty