Provider Demographics
NPI:1023226446
Name:PREMIER HEALTH CENTER LLC
Entity type:Organization
Organization Name:PREMIER HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-648-4567
Mailing Address - Street 1:2165 HWY 78
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DORA
Mailing Address - State:AL
Mailing Address - Zip Code:35062
Mailing Address - Country:US
Mailing Address - Phone:205-648-4567
Mailing Address - Fax:205-648-4551
Practice Address - Street 1:2165 HWY 78
Practice Address - Street 2:SUITE 100
Practice Address - City:DORA
Practice Address - State:AL
Practice Address - Zip Code:35062
Practice Address - Country:US
Practice Address - Phone:205-648-4567
Practice Address - Fax:205-648-4551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty