Provider Demographics
NPI:1336800010
Name:URGENT CARE OF FAIRHOPE LLC
Entity Type:Organization
Organization Name:URGENT CARE OF FAIRHOPE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAMMY
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:BEALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-377-8811
Mailing Address - Street 1:8096 TWIN BEECH RD UNIT 150
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-7195
Mailing Address - Country:US
Mailing Address - Phone:251-278-6795
Mailing Address - Fax:
Practice Address - Street 1:8096 TWIN BEECH RD UNIT 150
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-7195
Practice Address - Country:US
Practice Address - Phone:251-278-6795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty