Provider Demographics
NPI:1437938685
Name:CULLMAN FAMILY MEDICINE
Entity Type:Organization
Organization Name:CULLMAN FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:SELIGSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-416-6579
Mailing Address - Street 1:4227 OLD BROOK LN
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35243-1717
Mailing Address - Country:US
Mailing Address - Phone:610-416-6579
Mailing Address - Fax:
Practice Address - Street 1:111 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-1902
Practice Address - Country:US
Practice Address - Phone:256-708-2826
Practice Address - Fax:256-573-1076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty