Provider Demographics
NPI:1639394513
Name:RED MOUNTAIN FAMILY MEDICINE, PC
Entity type:Organization
Organization Name:RED MOUNTAIN FAMILY MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:HOPPER
Authorized Official - Last Name:ARMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-933-4520
Mailing Address - Street 1:600 BEACON PKWY W STE 860
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-3118
Mailing Address - Country:US
Mailing Address - Phone:205-933-4520
Mailing Address - Fax:205-933-4530
Practice Address - Street 1:600 BEACON PKWY W STE 860
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-3118
Practice Address - Country:US
Practice Address - Phone:205-933-4520
Practice Address - Fax:205-933-4530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X
AL12403207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty